Bowyer Samantha, Webb Suzanne, Millward Michael, Jasas Kevin, Blacker David, Nowak Anna
Department of Medical Oncology, Sir Charles Gairdner Hospital, University of Western Australia, Australia.
Asia Pac J Clin Oncol. 2011 Jun;7(2):180-4. doi: 10.1111/j.1743-7563.2010.01374.x. Epub 2011 Jan 14.
We report two cases of the rare neurological paraneoplastic syndrome, limbic encephalitis, as the initial presentation of small cell lung cancer. The first case responded to treatment of the underlying malignancy, while the second required more acute treatment in the intensive care setting. In this case, initial treatment was with immunosuppression to achieve a degree of stability before the underlying malignancy could be treated. Both cases had significant improvement in neurological function. These cases highlight the importance of directed investigation to try and identify an underlying malignancy in patients in whom a diagnosis of limbic encephalitis is made, and the difficulty in managing such patients.
我们报告了两例罕见的神经系统副肿瘤综合征——边缘叶脑炎，它们均为小细胞肺癌的首发表现。第一例患者对潜在恶性肿瘤的治疗有反应，而第二例患者在重症监护环境中需要更紧急的治疗。在该病例中，初始治疗采用免疫抑制，以在治疗潜在恶性肿瘤之前达到一定程度的稳定。两例患者的神经功能均有显著改善。这些病例凸显了对于诊断为边缘叶脑炎的患者进行针对性检查以试图识别潜在恶性肿瘤的重要性，以及管理此类患者的困难。
