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A Case of Cranial Nerve Palsy as a Paraneoplastic Syndrome in Non-Small Cell Lung Cancer

비소세포폐암 환자에서 부종양성 증후군의 증상으로 발생한 좌측 3, 4 뇌신경마비 1예

  • Lee, Young-Mi (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Sim, Woo-Ho (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Yoon, Sun-Och (Department of Pathology, Yonsei University College of Medicine) ;
  • Kim, Song-Yee (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Park, Jung-Soo (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kho, Bo-Gun (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Byun, Min-Kwang (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Choi, Young-Chul (Department of Neurology, Yonsei University College of Medicine) ;
  • Kim, Hyung-Jung (Department of Internal Medicine, Yonsei University College of Medicine)
  • 이영미 (연세대학교 의과대학 내과학교실) ;
  • 심우호 (연세대학교 의과대학 내과학교실) ;
  • 윤선옥 (연세대학교 의과대학 병리학교실) ;
  • 김송이 (연세대학교 의과대학 내과학교실) ;
  • 박정수 (연세대학교 의과대학 내과학교실) ;
  • 고보건 (연세대학교 의과대학 내과학교실) ;
  • 변민광 (연세대학교 의과대학 내과학교실) ;
  • 최영철 (연세대학교 의과대학 신경과학교실) ;
  • 김형중 (연세대학교 의과대학 내과학교실)
  • Received : 2010.08.12
  • Accepted : 2010.10.18
  • Published : 2011.02.28

Abstract

Paraneoplastic neurologic syndrome is a group of assorted disorders resulting from damage to the nervous system in cancer, remote from primary site, and not related to metastasis, infection, or metabolic disorder associated with cancer. Patient with small cell lung cancer sometimes shows various neurological syndromes, but patient with non-small cell lung cancer rarely shows neurologic syndromes and few antineuronal antibodies have been found. Here, we report a case of 53-year-old male patient who developed ptosis and extraocular muscular limitation of left eye due to third and forth cranial nerve palsy in non-small cell lung cancer without brain metastasis. These neurologic symptoms improved after lobectomy without any other treatment immunotherapy.

Keywords

References

  1. Darnell RB, Posner JB. Paraneoplastic syndromes involving the nervous system. N Engl J Med 2003;349: 1543-54. https://doi.org/10.1056/NEJMra023009
  2. Toothaker TB, Rubin M. Paraneoplastic neurological syndromes: a review. Neurologist 2009;15:21-33. https://doi.org/10.1097/NRL.0b013e3181870aa2
  3. Graus F, Delattre JY, Antoine JC, Dalmau J, Giometto B, Grisold W, et al. Recommended diagnostic criteria for paraneoplastic neurological syndromes. J Neurol Neurosurg Psychiatry 2004;75:1135-40. https://doi.org/10.1136/jnnp.2003.034447
  4. Honnorat J, Antoine JC. Paraneoplastic neurological syndromes. Orphanet J Rare Dis 2007;2:22. https://doi.org/10.1186/1750-1172-2-22
  5. Seute T, Leffers P, ten Velde GP, Twijnstra A. Neurologic disorders in 432 consecutive patients with small cell lung carcinoma. Cancer 2004;100:801-6. https://doi.org/10.1002/cncr.20043
  6. Hiasa Y, Kunishige M, Mitsui T, Kondo S, Kuriwaka R, Shigekiyo S, et al. Complicated paraneoplastic neurological syndromes: a report of two patients with small cell or non-small cell lung cancer. Clin Neurol Neurosurg 2003;106:47-9. https://doi.org/10.1016/S0303-8467(03)00059-3
  7. Fujimoto S, Kumamoto T, Ito T, Sannomiya K, Inuzuka T, Tsuda T. A clinicopathological study of a patient with anti-Hu-associated paraneoplastic sensory neuronopathy with multiple cranial nerve palsies. Clin Neurol Neurosurg 2002;104:98-102. https://doi.org/10.1016/S0303-8467(01)00190-1
  8. Dalmau J, Graus F, Rosenblum MK, Posner JB. Anti- Hu--associated paraneoplastic encephalomyelitis/sensory neuronopathy. A clinical study of 71 patients. Medicine (Baltimore) 1992;71:59-72.
  9. Reddy RV, Vakili ST. Midbrain encephalitis as a remote effect of a malignant neoplasm. Arch Neurol 1981;38: 781-2. https://doi.org/10.1001/archneur.1981.00510120081016
  10. Pillay N, Gilbert JJ, Ebers GC, Brown JD. Internuclear ophthalmoplegia and "optic neuritis": paraneoplastic effects of bronchial carcinoma. Neurology 1984;34:788-91. https://doi.org/10.1212/WNL.34.6.788
  11. Vedeler CA, Antoine JC, Giometto B, Graus F, Grisold W, Hart IK, et al. Management of paraneoplastic neurological syndromes: report of an EFNS Task Force. Eur J Neurol 2006;13:682-90. https://doi.org/10.1111/j.1468-1331.2006.01266.x
  12. Darnell RB. Onconeural antigens and the paraneoplastic neurologic disorders: at the intersection of cancer, immunity, and the brain. Proc Natl Acad Sci USA 1996;93:4529-36. https://doi.org/10.1073/pnas.93.10.4529
  13. Furneaux HF, Reich L, Posner JB. Autoantibody synthesis in the central nervous system of patients with paraneoplastic syndromes. Neurology 1990;40:1085-91. https://doi.org/10.1212/WNL.40.7.1085
  14. Vernino S, O'Neill BP, Marks RS, O'Fallon JR, Kimmel DW. Immunomodulatory treatment trial for paraneoplastic neurological disorders. Neuro Oncol 2004;6:55-62. https://doi.org/10.1215/S1152851703000395

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