Armağan Haydar, Tüzün Erdem, Içöz Sema, Birişik Omer, Ulusoy Canan, Demir Gökhan, Altıntaş Ayşe, Akman-Demir Gülşen
Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
J Spinal Cord Med. 2012 Jul;35(4):267-9. doi: 10.1179/2045772312Y.0000000018.
Long extensive transverse myelitis (LETM) seldom develops in patients with breast cancer who are aquaporin-4 antibody (Aqp-4 Ab)-positive. Whether this association is coincidental is not well understood.
A 62-year-old woman presented with treatment-resistant LETM and Aqp-4 Ab. Two months later, a stage 3 invasive ductal carcinoma was detected in her right breast. Following tumor resection and chemotherapy, her neurologic symptoms and magnetic resonance imaging findings significantly improved and serum Aqp-4 Ab disappeared. The breast tumor samples of this patient and neurologically normal patients showed inflammatory infiltrates and Aqp-4 expressing cells.
CONCLUSION/CLINICAL RELEVANCE: The temporal association between tumor treatment, amelioration of clinical findings, and seroreversion suggest that coexistence of cancer and LETM is not coincidental. Cancer screening should be considered at least in treatment-resistant LETM cases.
水通道蛋白4抗体（Aqp-4 Ab）阳性的乳腺癌患者很少发生长节段横贯性脊髓炎（LETM）。这种关联是否偶然尚不清楚。
一名62岁女性出现难治性LETM且Aqp-4 Ab阳性。两个月后，在她的右乳发现了3期浸润性导管癌。肿瘤切除和化疗后，她的神经症状和磁共振成像结果显著改善，血清Aqp-4 Ab消失。该患者和神经功能正常患者的乳腺肿瘤样本均显示有炎性浸润和Aqp-4表达细胞。
结论/临床意义：肿瘤治疗、临床症状改善和血清转阴之间的时间关联表明，癌症与LETM并存并非偶然。至少在难治性LETM病例中应考虑进行癌症筛查。
