Referenced in: none

Automatically associated channels: ClC4

Title: [A case of cT0N2M0 small cell lung cancer with Lambert-Eaton myasthenic syndrome]

Authors: Jun Tsukiji, Takeshi Kaneko, Haruhiro Saito, Masayoshi Kobayashi, Nobumasa Kakemizu, Shigeru Komatsu, Harumi Nishiyama, Hiroko Amano, Kenji Miura, Takashi Satoh, Takeshi Shinohara, Wataru Mishima, Yasushi Yamakawa, Ryuuichi Nishihira, Akira Miyashita, Kazumasa Noda, Yoshiaki Ishigatsubo, Takeshi Matsuse

Journal, date & volume: , 2004 Sep , 42, 820-4

PubMed link: http://www.ncbi.nlm.nih.gov/pubmed/15500150

Abstract
We encountered a very rare case of cT0N2M0 small cell lung cancer (SCLC) with Lambert-Eaton myasthenic syndrome (LEMS). A 69-year-old man with a complaint of muscle weakness was admitted to our hospital. Although his chest radiograph on admission showed no abnormal findings, CT scanning detected a mediastinal lymphadenopathy. Also, 2-[18F]-2-fluorodeoxy-D-glucose position emission tomography (FDG-PET) revealed increased accumulation in the same portion in the mediastinum. A diagnosis of LEMS was made from the distinctive electromyogram (EMG) findings (waning and waxing phenomenon in response to low-and high-frequency repetitive stimulation, respectively) in combination with the increased serum level of a P/Q-type anti-voltage-gated calcium channel (VGCC) antibody. Subsequent histopathological diagnosis by mediastinoscopic resection of a paraaortic lymph node was small cell carcinoma. No distant metastasis was detected by MRI of the brain, abdominal CT scan or an FDG-PET. Eight courses of chemotherapy (carboplatin + etoposide) with radiotherapy of the mediastinum (for a total dose of 45 Gy) was performed. A decreased serum level of P/Q-type anti-VGCC antibody titers followed by marked improvement of neurological dysfunction (muscle weakness, gait disturbance and scanning speech) and of an EMG finding (a loss of waning phenomenon) was observed. A close relationship between reduction of the antibody titers and improvement of neurological symptoms after the therapy was noticed. It was suggested that monitoring the level of a P/Q-type anti-VGCC antibody titer in the serum is important for evaluating the efficacy of chemotherapy for LEMS associated with SCLC.