Kon Tomoya, Ueno Tatsuya, Suzuki Chieko, Nunomura Jinichi, Igarashi Shohei, Sato Tsugumi, Tomiyama Masahiko
Department of Neurology, Aomori Prefectural Central Hospital, Aomori, Japan.
Department of Gastroenterology, Aomori Prefectural Central Hospital, Aomori, Japan.
J Neuroimmunol. 2017 Aug 15;309:38-40. doi: 10.1016/j.jneuroim.2017.05.009. Epub 2017 May 17.
Autoimmune diseases are sometimes associated with neoplasms. A 70-year-old Japanese woman with myelitis, seropositive for aquaporin-4 (AQP4) antibody, was diagnosed with neuromyelitis optica spectrum disorder (NMOSD); thereafter an esophageal squamous cell carcinoma was identified. Immunohistochemically, her cancer was anti-AQP4 antibody negative. Her symptoms, imaging findings and AQP4 titer markedly improved with corticosteroid and anti-cancer therapies. Although AQP4 may be a paraneoplastic antigen, paraneoplastic syndrome could not be definitively diagnosed in this case. Nevertheless, this is the first report of an association between AQP4 antibody-seropositive NMOSD and esophageal cancer. The possibility of underlying malignancy should be considered in patients diagnosed with NMOSD.
自身免疫性疾病有时与肿瘤相关。一名70岁的日本女性，患有脊髓炎，水通道蛋白4（AQP4）抗体血清学阳性，被诊断为视神经脊髓炎谱系障碍（NMOSD）；此后发现患有食管鳞状细胞癌。免疫组织化学检查显示，她的癌症抗AQP4抗体阴性。经皮质类固醇和抗癌治疗后，她的症状、影像学表现和AQP4滴度明显改善。虽然AQP4可能是一种副肿瘤抗原，但本例不能明确诊断为副肿瘤综合征。然而，这是第一例关于AQP4抗体血清学阳性的NMOSD与食管癌之间关联的报告。对于诊断为NMOSD的患者，应考虑潜在恶性肿瘤的可能性。
