scholarly journals Nicotinic ganglionic acetylcholine receptor autoantibodies associated with paraneoplastic disease in a neuropsychiatric patient

2021 ◽  
Vol 14 (5) ◽  
pp. e240824
Author(s):  
Catherine Stauffer ◽  
Daniel A Llano ◽  
Suzanna Kitten
Keyword(s):  
Acetylcholine Receptor ◽  
Incidental Finding ◽  
Neuropsychiatric Symptoms ◽  
Small Cell ◽  
Paraneoplastic Syndromes ◽  
Papillary Thyroid ◽  
Small Cell Lung ◽  
Diverse Range ◽  
Paraneoplastic Disease ◽  
Autoimmune Encephalopathy

Nicotinic ganglionic acetylcholine receptor autoantibodies (alpha-3-AChR Ab) are associated with paraneoplastic syndromes when present in low elevations. These antibodies can be tested for as part of an autoimmune encephalopathy panel in neuropsychiatric patients; a mildly elevated titre of alpha-3-AChR Ab that may start as an incidental finding can lead to the diagnosis of a previously undetected cancer. While alpha-3-AChR Ab are most typically associated with thymomas and small cell lung cancer, the presence of these antibodies can suggest a diverse range of other cancers. This case presents a patient with longstanding neuropsychiatric symptoms and possible functional hypothyroidism for whom a low elevation in alpha-3-AChR Ab led to the finding of papillary thyroid carcinoma.

scholarly journals Negativation of PD-L1 Postoperatively in Initially Inoperable Stage III Non-Small Cell Lung Cancer Treated with Pembrolizumab: Two Case Reports

2019 ◽  
Vol 12 (2) ◽  
pp. 421-425
Author(s):  
Fadi Nasr ◽  
Ahmad Al Ghoche ◽  
Roland Eid ◽  
Lewis Nasr ◽  
Saada Diab ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Incidental Finding ◽  
Case Reports ◽  
Small Cell ◽  
Stage Iii ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Iiia Nsclc

Stage III non-small cell lung cancer is a border line stage between localized and metastatic disease. PDL-1 is gaining an important role in the therapeutic arsenal of lung cancer, the most frequent cancer worldwide. We report for the first time a negativation of PDL-1 status in 2 cases of stage IIIA NSCLC with conversion to operable disease after using immunotherapy. The first patient was a 59-year old female diagnosed incidentally to have stage IIIA inoperable NSCLC that was treated with combination chemo-immunotherapy, and converted to operable disease with a negative PD-L1 in the postoperative setting. The second case is that of a 56-year old male that also had an inoperable stage IIIA NSCLC treated with chemotherapy first line followed by pembrolizumab at progression, then operated after surgical conversion, with negative PD-L1 postoperatively. In front of these findings, further work should be done to elucidate if the reverse of the PDL-1 status and the conversion to operability were due to the use of immunotherapy or to an incidental finding. If confirmed, it may have a therapeutic impact.

Two Cases of Non-Small Cell Lung Cancer Masquerading as Metastatic Papillary Thyroid Cancer

2012 ◽  
Vol 5 (2) ◽  
pp. 157
Author(s):  
Ju Hee Lee ◽  
Se-Hoon Lee ◽  
Hye Sook Min ◽  
Ji-hoon Kim ◽  
Do Joon Park ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Thyroid Cancer ◽  
Small Cell Lung Cancer ◽  
Papillary Thyroid Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Papillary Thyroid ◽  
Small Cell Lung

scholarly journals Beyond the Dual Paraneoplastic Syndromes of Small-Cell Lung Cancer with ADH and ACTH Secretion: A Case Report with Literature Review and Future Implications

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Krishna Adit Agarwal ◽  
Myat Han Soe
Keyword(s):  
Lung Cancer ◽  
Case Report ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Hormone Secretion ◽  
Small Cell ◽  
Paraneoplastic Syndromes ◽  
Prognostic Impact ◽  
Small Cell Lung ◽  
Acth Secretion

We present a case of small-cell lung cancer (SCLC) with syndrome of inappropriate antidiuretic hormone secretion (SIADH) in which serum sodium gradually normalized with the onset of hypertension, refractory hypokalemia, and chloride-resistant metabolic alkalosis due to ectopic adrenocorticotrophic hormone (ACTH) secretion (EAS). In this case report, we discuss the diagnostic challenges of dual paraneoplastic syndromes with SIADH and EAS, management of SCLC with paraneoplastic endocrinopathies, and their prognostic impact on SCLC. In addition, we discuss neuroendocrine differentiation and ectopic hormone production in relation to intratumoral heterogeneity in SCLC and propose tumor microenvironment and hormonal and metabolic dependence as important determinants of tumor growth and survival.

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