González del Val R, García Arroyo R, Villanueva J A, Moro E, Pérez Manga G, García Gómez R
Servicio de Oncología Médica, Hospital General Gregorio Marañón, Madrid.
Med Clin (Barc). 1992 Nov 28;99(18):701-4.
Subacute paraneoplastic cerebellous degeneration is a rare syndrome which is found in less than 1% of patients with cancer. Small cell cancer of the lung and of the ovary are the two neoplasms most frequently associated to this entity. Two patients with small cell lung cancer who initially had a cerebellous syndrome in which no sign of macroscopic cerebellous lesion could be demonstrated by either computerized tomography or nuclear magnetic resonance of the head are presented. One of the patients was evaluated at autopsy. Both patients were treated with polychemotherapy with which partial response was obtained. Neurologic symptomatology was not alleviated in the first patient with death due to bronchopneumonia at 5.5 months of initiation of the disease, while improvement of the cerebellous paraneoplastic syndrome was achieved in the second patient. The different evolution of subacute paraneoplastic cerebellous degeneration in two patients in whom antibodies were not demonstrated and in whom initial response of the tumor to chemotherapy was achieved may be explained by the second patient having undergone prolonged treatment of 6 cycles suggesting a strict relation ship between the tumor and subacute cerebellous degeneration which, to date, remains unknown.
亚急性副肿瘤性小脑变性是一种罕见综合征,在不到1%的癌症患者中出现。肺癌和卵巢小细胞癌是与此病症最常相关的两种肿瘤。本文报告了两名小细胞肺癌患者,他们最初患有小脑综合征,但头部计算机断层扫描或核磁共振均未显示小脑有宏观病变迹象。其中一名患者接受了尸检。两名患者均接受了多药化疗并获得部分缓解。第一名患者在疾病开始5.5个月时因支气管肺炎死亡,神经症状未得到缓解,而第二名患者的小脑副肿瘤综合征得到改善。两名患者均未检测到抗体,肿瘤对化疗最初有反应,但亚急性副肿瘤性小脑变性的演变不同,这可能是因为第二名患者接受了长达6个周期的延长治疗,提示肿瘤与亚急性小脑变性之间存在迄今仍不明的严格关系。