Fujii M, Tanaka H, Saito T, Kaneko S, Teramoto S, Murakami S, Omote T, Kashiwagi M, Tanaka K, Abe S
Third Department of Internal Medicine, Sapporo Medical University School of Medicine, Japan.
Nihon Kokyuki Gakkai Zasshi. 1999 Dec;37(12):992-6.
A 57-year-old man was admitted to our hospital in November 1997 because of dysarthria, progressive ataxia, generalized weakness, and incoordination in both hands. He had been aware of the dysarthria 6 months earlier. Chest roentgenograms and computed tomographic films disclosed a 5 cm x 6 cm mass in the left S3b. The patient was given a diagnosis of small cell lung cancer (T3N2M0, stage IIIA) associated with paraneoplastic cerebellar degeneration (PCD). Three courses of chemotherapy (carboplatin and etoposide) eliminated the tumor and slightly alleviated the PCD symptoms. In March 1998, electromyograms revealed a fall in the single-stimulated M wave and a waxing phenomenon that had not been observed on admission. Anti-P/Q type voltage gated calcium channel antibody was detected in serum samples obtained on admission and after chemotherapy. These findings confirmed an association with Lambert-Eaton myasthenic syndrome. No relapse of the tumor has been observed 15 months after the last course of chemotherapy.
一名57岁男性于1997年11月因构音障碍、进行性共济失调、全身无力和双手不协调而入住我院。他在6个月前就已察觉到构音障碍。胸部X线片和计算机断层扫描显示左肺S3b区有一个5厘米×6厘米的肿块。该患者被诊断为小细胞肺癌(T3N2M0,ⅢA期)伴副肿瘤性小脑变性(PCD)。三个疗程的化疗(卡铂和依托泊苷)消除了肿瘤,并使PCD症状稍有缓解。1998年3月,肌电图显示单次刺激的M波下降以及入院时未观察到的波幅递增现象。在入院时及化疗后的血清样本中检测到抗P/Q型电压门控钙通道抗体。这些发现证实了与兰伯特-伊顿肌无力综合征有关。在最后一个疗程化疗后15个月未观察到肿瘤复发。