[Subacute sensory neuropathy associated with carcinoma--an autopsy case report and an analysis of Japanese cases].

A 68-year-old man was admitted to our hospital because of numbness in the hands and feet, and unsteady gait in August, 1986. On neurological examination, deep tendon reflexes were absent in all limbs without pathological reflexes. Superficial and deep sensory disturbances of a glove and stocking type up to the level of the elbow and the knee were observed. Pseudoathetosis was noted in the hands. His gait was ataxic and Romberg sign was positive. Muscle strength was slightly decreased. Sural nerve biopsy showed severe loss of large myelinated fibers. Laboratory studies for malignancy showed lung cancer (Squamous cell carcinoma). Left pneumonectomy was performed in November, 1986, but he died in March, 1987. At autopsy, neither metastasis nor direct infiltration of malignant cells in the central and peripheral nervous systems were present macroscopically and histopathologically. Degeneration of the dorsal root ganglion and the posterior columns of the spinal cord were remarkable. Since 1955, only 9 cases of subacute sensory neuropathy had been reported in Japan. We analysed 10 Japanese cases (including our case) to clarify the clinicopathological features of subacute sensory neuropathy. Clinically, ataxic gait, paresthesia, deep sensory disturbance, and depression of deep tendon reflexes were present in the majority of the cases. Neuropathologically, neuronal cell loss and degeneration of the dorsal root ganglion, posterior roots and posterior columns of the spinal cord were universal findings.