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腺性膀胱炎引起的副肿瘤性神经综合征:一例报告及文献复习

Paraneoplastic neurological syndrome caused by cystitis glandularis: A case report and literature review.

作者信息

Zhao Dong-Hui, Li Qing-Jun

机构信息

Department of Pathology, University of Chinese Academy of Sciences-Shenzhen Hospital, Shenzhen518000, Guangdong Province, China.

Department of Neurology, University of Chinese Academy of Sciences-Shenzhen Hospital, Shenzhen518000, Guangdong Province, China.

出版信息

World J Clin Cases. 2022 Nov 16;10(32):11827-11834. doi: 10.12998/wjcc.v10.i32.11827.

Abstract

BACKGROUND

Paraneoplastic neurological syndrome (PNS) is an unusual event. PNS caused by cystitis glandularis (CG) or a bladder tumor is extremely rare; hence, missed diagnosis or misdiagnosis can easily occur. To date, approximately 21 cases have been reported in PubMed.

CASE SUMMARY

We report a case of PNS caused by CG and describe the clinical and imaging features. The main clinical feature was advanced cognitive impairment, and early clinical features were memory impairment, decreased computational ability, and abnormal behavior. Later clinical features were dementia, vomiting, inability to eat and walk, urinary incontinence, and hematuria. Imaging features on cranial magnetic resonance imaging were diffuse white matter lesions. Paraneoplastic tumor markers were normal. A total abdominal computed tomography scan showed multiple thickened areas on the bladder wall with local prominence. Cystoscopy revealed a volcanic protuberance on the posterior wall of the bladder with a diameter of 6 cm and no pedicle. The postoperative pathological diagnosis was CG. The patient recovered well following resection of CG. PNS cases caused by previous bladder tumors can be retrieved from PubMed to describe the clinical signs and prognosis of PNS.

CONCLUSION

The main clinical feature of PNS caused by CG was dementia, and the imaging features were diffuse cerebral white matter lesions. Resection of CG lesions is the fundamental treatment for PNS induced by CG. This case highlights the importance of etiological treatment.

摘要

背景

副肿瘤性神经系统综合征(PNS)是一种罕见病症。由腺性膀胱炎(CG)或膀胱肿瘤引起的PNS极为罕见;因此,容易出现漏诊或误诊。截至目前,PubMed上报道了约21例病例。

病例摘要

我们报告1例由CG引起的PNS病例,并描述其临床和影像学特征。主要临床特征为重度认知障碍,早期临床特征为记忆障碍、计算能力下降和行为异常。后期临床特征为痴呆、呕吐、无法进食和行走、尿失禁及血尿。头颅磁共振成像的影像学特征为弥漫性白质病变。副肿瘤性肿瘤标志物正常。全腹部计算机断层扫描显示膀胱壁多处增厚并局部隆起。膀胱镜检查发现膀胱后壁有一火山样隆起,直径6 cm,无蒂。术后病理诊断为CG。切除CG后患者恢复良好。既往膀胱肿瘤引起的PNS病例可从PubMed检索,以描述PNS的临床体征和预后。

结论

CG引起的PNS的主要临床特征为痴呆,影像学特征为弥漫性脑白质病变。切除CG病变是CG所致PNS的根本治疗方法。本病例突出了病因治疗的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfa7/9669863/6e5509cc7b04/WJCC-10-11827-g001.jpg

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