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小细胞肺癌所致神经系统副肿瘤综合征:一例报告

Neurological paraneoplastic syndrome caused by small cell lung cancer: a case report.

作者信息

Yan Wenxing, Wang Xinyu, Wang Ying, Liu Linlin

机构信息

Department of Radiotherapy, The Second Hospital of Jilin University, Changchun 130021, China.

出版信息

Transl Cancer Res. 2020 Apr;9(4):2999-3002. doi: 10.21037/tcr.2020.03.54.

Abstract

Paraneoplastic syndrome (PNS) is a term used to describe pathological changes in organ function among patients with malignancy that does not metastasize. Clinical manifestations affect nerve, digestive, hematopoietic, endocrine, bone, joint, and urinary function. Here we present the case of a 59-year-old male with PNS as the initial symptom of SCLC. PNS symptoms manifested as repeated attacks after surgery and chemotherapy. The severity of the patient's symptoms has rarely been reported. The tumor type involved most frequently is small-cell lung cancer (SCLC). Symptoms caused by PNS typically manifest earlier than those caused by the tumor. Immunohistochemical staining was positive for Syn, CgA, CD56, TTF-1, CK (AE1/AE3), Hu antibodies, and Ki67 (90%). Treatment remains challenging. A case of severe Neurological PNS caused by early small cell carcinoma was reported. Although the patient accepted surgery and postoperative radiotherapy and chemotherapy, symptoms persist. In this case report, treatment with pregabalin and antidepressant agents improved the patient's numbness. Currently, the patient has been followed-up for >3 years without any signs of recurrence and PNS. This case may inform future treatment of patients with PNS.

摘要

副肿瘤综合征(PNS)是一个用于描述未发生转移的恶性肿瘤患者器官功能病理变化的术语。临床表现影响神经、消化、造血、内分泌、骨骼、关节和泌尿功能。在此,我们报告一例以PNS为小细胞肺癌(SCLC)首发症状的59岁男性病例。PNS症状在手术和化疗后反复出现。该患者症状的严重程度鲜有报道。最常涉及的肿瘤类型是小细胞肺癌(SCLC)。PNS引起的症状通常比肿瘤引起的症状出现得更早。免疫组化染色Syn、CgA、CD56、TTF-1、CK(AE1/AE3)、Hu抗体及Ki67(90%)呈阳性。治疗仍然具有挑战性。报告了一例由早期小细胞癌引起的严重神经型PNS病例。尽管患者接受了手术及术后放疗和化疗,但症状仍持续存在。在本病例报告中,加巴喷丁和抗抑郁药治疗改善了患者的麻木症状。目前,该患者已随访3年多,无任何复发及PNS迹象。本病例可能为未来PNS患者的治疗提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5341/8798883/4a90203158a5/tcr-09-04-2999-f1.jpg

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