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一例罕见的长期感觉异常病例,通过抗SOX1抗体检测诊断为副肿瘤综合征。

A rare case of long-term paraesthesia diagnosed as a paraneoplastic syndrome by anti-SOX1 antibody determination.

作者信息

Mirallas Oriol, Rial Nuria, Martín-Cullell Berta, Recio-Iglesias Jesus

机构信息

Internal Medicine Department, Hospital Vall d'Hebron, Barcelona, Spain.

Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

出版信息

BMJ Case Rep. 2019 Jul 16;12(7):e228916. doi: 10.1136/bcr-2018-228916.

Abstract

Paraneoplastic syndromes (PS) are a rare presentation of cancer, most commonly associated with small cell lung cancer (SCLC), breast cancer and haematologic malignancies. The diagnosis of PS is challenging because it could affect multiple organ systems and it may present before the tumour is visible by imaging. We report a malignant tumour diagnosed in a male patient who referred long-term paraesthesia and proximal muscle strength loss. After ruling out common causes of polyneuropathy, the anti-SOX1 antibody gave light to the diagnosis. A pulmonary opacity in the upper right lobe was observed in the chest X-ray and a pulmonary tumour was later confirmed by CT scan. The biopsy of the cervical lymphadenopathy determined an SCLC, which caused a PS called Lambert-Eaton myasthenic syndrome (LEMS). Our case raises awareness of a rare PS presentation, which can be diagnosed by specific antibodies, allowing early diagnosis and treatment of lung cancer.

摘要

副肿瘤综合征(PS)是癌症的一种罕见表现,最常与小细胞肺癌(SCLC)、乳腺癌和血液系统恶性肿瘤相关。PS的诊断具有挑战性,因为它可影响多个器官系统,且可能在肿瘤通过影像学可见之前就出现。我们报告了一例男性患者,该患者出现长期感觉异常和近端肌肉力量丧失后被诊断为恶性肿瘤。在排除多发性神经病的常见病因后,抗SOX1抗体为诊断提供了线索。胸部X线检查发现右上叶有肺部混浊影,随后CT扫描证实为肺部肿瘤。颈部淋巴结病活检确定为SCLC,其导致了一种名为兰伯特-伊顿肌无力综合征(LEMS)的PS。我们的病例提高了对一种罕见PS表现的认识,这种表现可通过特异性抗体进行诊断,从而实现肺癌的早期诊断和治疗。

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Paraneoplastic Disorders.副肿瘤综合征
Continuum (Minneap Minn). 2017 Dec;23(6, Neuro-oncology):1653-1679. doi: 10.1212/CON.0000000000000542.
3
Prevalence of anti-SOX1 reactivity in various neurological disorders.各种神经系统疾病中抗SOX1反应性的患病率。
J Neurol Sci. 2016 Oct 15;369:342-346. doi: 10.1016/j.jns.2016.09.002. Epub 2016 Sep 4.
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Paraneoplastic disorders.副肿瘤综合征
Continuum (Minneap Minn). 2015 Apr;21(2 Neuro-oncology):452-75. doi: 10.1212/01.CON.0000464180.89580.88.
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