A Case of Small Cell Lung Cancer with Diverse Neurological Symptoms due to Paraneoplastic Neurological Syndrome

Abstract Background Paraneoplastic neurological syndromes (PNS) are rare disorders affecting any part of the central, peripheral or autonomic nervous system that occur in association with cancer. Among cancer patients, less than 1% overall develop PNS. Anti- SOX1 antibodies positive paraneoplastic neurological disorders are rare and most often associated with small cell lung cancer (SCLC). Case presentation Herein, we report a case of a 61-year-old male presented with an unusual anti- SOX1 positive PNS. Electrodiagnostic study showed notable low amplitude motor potentials and high amplitude motor potentials of the right tibialis anterior suggesting the presence of Lambert–Eaton myasthenic syndrome (LEMS). Typical MRI and PET-CT found a hyperintense lesion with contrast enhancement in the thorax in front of 5-6 centrum of vertebrae, and thoracoscopic biopsy revealed pathological findings for SCLC. Because the diagnosis was made in time, the patient is currently receiving chemotherapy and radiotherapy for the cancer at Chinese PLA General Hospital, and the clinical symptoms improved obviously. Conclusions The comprehensive screening of onconeural antibodies in PNS-suspicious cases combined with early diagnosis and treatment of tumor are important for achieving a good outcome.

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Small Cell Lung Cancer Patient with Profound Hyponatremia and Acute Neurological Symptoms: An Effective Treatment with Fludrocortisone

Case Reports in Oncological Medicine ◽

10.1155/2015/286029 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Jana Jaal ◽

Tõnu Jõgi ◽

Alan Altraja

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Serum Sodium ◽

Neurological Status ◽

Small Cell ◽

Neurological Symptoms ◽

Pharmacological Intervention ◽

Small Cell Lung ◽

Continuous Administration

Hyponatremia is a frequent electrolyte abnormality in patients with small cell lung cancer (SCLC). Being usually asymptomatic, hyponatremia may cause symptoms like nausea, fatigue, disorientation, headache, muscle cramps, or even seizures, particularly if severe and rapid decrease of serum sodium levels occurs. Here we report a case of SCLC patient with severe hyponatremia and acute neurological symptoms that developed 2 days after the first course of second-line chemotherapy, most probably due to the release of antidiuretic hormone (ADH, also known as arginine vasopressin) during lysis of the tumour cells. Initial treatment consisted of continuous administration of hypertonic saline that resulted in improvement of patient’s neurological status. However, to obtain a persistent increase in serum sodium level, pharmacological intervention with oral fludrocortisone 0.1 mg twice daily was needed. We can therefore conclude that mineralocorticoids may be used to correct hyponatremia in SCLC patients when appropriate.

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Immune Checkpoint Inhibitor-Induced Limbic Encephalitis during Treatment with Atezolizumab in a Patient with Small-Cell Lung Cancer: A Case Report and Review of the Literature

Case Reports in Immunology ◽

10.1155/2022/9290922 ◽

2022 ◽

Vol 2022 ◽

pp. 1-5

Author(s):

Koki Nakashima ◽

Yoshiki Demura ◽

Kosuke Kurokawa ◽

Toshihiro Takeda ◽

Norihiro Jikuya ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Immune Checkpoint ◽

Limbic Encephalitis ◽

Checkpoint Inhibitors ◽

Brain Magnetic Resonance Imaging ◽

Paraneoplastic Neurological Syndrome ◽

Small Cell ◽

Small Cell Lung

Paraneoplastic neurological syndrome (PNS) is associated with malignancies, including small-cell lung cancer. Recently, PNS cases among patients with small-cell lung cancer (SCLC) induced by immune checkpoint inhibitors have increased. We herein report a 66-year-old man with SCLC who developed disorientation, dysphagia, and gait disturbance after three courses of treatment with atezolizumab. Brain magnetic resonance imaging revealed a high-intensity area in the bilateral temporal lobes. Blood test results were positive for anti-Hu and anti-Zic4 antibodies, which led to the diagnosis of limbic encephalitis as PNS. Some symptoms improved with intravenous administration of steroids and immunoglobulins.

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