Isobe Kazutoshi, Nagata Riya, Ota Hiroki, Sugino Keishi, Shibuya Kazutoshi, Homma Sakae
Department of Respiratory Medicine, Toho University Omori Medical Center.
Nihon Kokyuki Gakkai Zasshi. 2011 Aug;49(8):602-6.
A 75-year-old woman received a diagnosis of small-cell lung cancer (T1N2M0, stage IIIA, limited disease) in January 2009. She received 4 cycles of chemotherapy with etoposide and carboplatin and concurrent radiotherapy (50 Gy/25 Fr) which yielded a complete response. However, recurrence of her small-cell lung cancer occurred in a mediastinal lymph node and the ribs in November 2009. During the 2nd cycle of second-line chemotherapy with nogitecan, she was readmitted to our hospital complaining of amnesia, periods of unconsciousness and convulsions. Her laboratory data on admission revealed normal serum electrolyte and cerebrospinal fluid levels, and electroencephalogram findings. Her neurological symptoms, which mimicked limbic encephalitis improved after steroid pulse therapy plus third-line chemotherapy with amrubicin. The final diagnosis was paraneoplastic limbic encephalitis by positive serum voltage-gated calcium channel antibodies. We hereby report a rare case of small-cell lung cancer associated with paraneoplastic limbic encephalitis during chemotherapy.
一名75岁女性于2009年1月被诊断为小细胞肺癌（T1N2M0，IIIA期，局限期）。她接受了4个周期的依托泊苷和卡铂化疗以及同步放疗（50 Gy/25次分割），获得了完全缓解。然而，2009年11月其小细胞肺癌在纵隔淋巴结和肋骨复发。在接受诺维本二线化疗的第2周期时，她因失忆、意识丧失和抽搐再次入院。入院时她的实验室检查数据显示血清电解质和脑脊液水平正常，脑电图检查结果也正常。经类固醇冲击治疗加用阿柔比星三线化疗后，其类似边缘叶脑炎的神经症状有所改善。血清电压门控钙通道抗体阳性，最终诊断为副肿瘤性边缘叶脑炎。我们在此报告1例化疗期间发生的与副肿瘤性边缘叶脑炎相关的小细胞肺癌罕见病例。
