title: Lung cancer associated with seronegative myasthenia gravis.
abstract: A 64-year-old man presented with diplopia, muscle weakness, a pulmonary nodule and mediastinal widening on a chest radiograph. He was diagnosed with clinical stage IIIA (T2aN2M0) lung cancer. His neurological symptoms worsened following the initiation of thoracic radiation therapy (60 Gy) and chemotherapy. A diagnosis of myasthenia gravis (MG) was confirmed with a repetitive nerve stimulation test that showed a waning pattern, and a positive edrophonium test, although neither anti-acetylcholine receptor antibodies nor anti-muscle-specific tyrosine kinase antibodies were detected. The ptosis and limb muscle weakness improved with prednisolone and acetylcholinesterase inhibitor treatment, and a partial response of the lung cancer to chemoradiotherapy was obtained. However, the ptosis and limb muscle weakness worsened again following a recurrence of the lung cancer. The herein described case, in which lung cancer and MG occurred and recurred simultaneously, suggests that MG can develop as a paraneoplastic syndrome of lung cancer.
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Niimi
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Nagata
authors.forename: Naoko
authors.initials: N
authors.lastname: Murata
authors.forename: Masako
authors.initials: M
authors.lastname: Sato
authors.forename: Jun
authors.initials: J
authors.lastname: Tanaka
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Horio
authors.forename: Hiroto
authors.initials: H
authors.lastname: Takiguchi
authors.forename: Hiromi
authors.initials: H
authors.lastname: Tomomatsu
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Tomomatsu
authors.forename: Naoki
authors.initials: N
authors.lastname: Hayama
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Oguma
authors.forename: Takuya
authors.initials: T
authors.lastname: Aoki
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Urano
authors.forename: Tadashi
authors.initials: T
authors.lastname: Abe
authors.forename: Chie
authors.initials: C
authors.lastname: Inomoto
authors.forename: Shunya
authors.initials: S
authors.lastname: Takizawa
authors.forename: Koichiro
authors.initials: K
authors.lastname: Asano
mesh_terms: D001763:Blepharoptosis / Q000150:complications; D004172:Diplopia / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D009364:Neoplasm Recurrence, Local / Q000150:complications; D009367:Neoplasm Staging; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000503:physiopathology; D011239:Prednisolone / Q000627:therapeutic use; D020794:Receptor Protein-Tyrosine Kinases / Q000276:immunology
chemical_list: D011239:Prednisolone; D020794:Receptor Protein-Tyrosine Kinases