Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Neurosurgery, Johns Hopkins Medicine, Baltimore, Maryland, USA.
BMJ Case Rep. 2023 Feb 10;16(2):e251770. doi: 10.1136/bcr-2022-251770.
Paraneoplastic syndromes are rare abnormal endocrine or immune responses triggered by neoplasms. Chronic inflammatory demyelinating polyneuropathy (CIDP) is one such example. CIDP is an acquired, immune-mediated neuropathy affecting the peripheral nerves and nerve roots. It is associated with many types of cancers, especially haematological malignancies. We report the case of a man in his 60s who presented to the emergency department with acute symptoms of upper and lower extremity paresis and decreased sensation in the toes and tips of his fingers. Laboratory tests were normal. Electrodiagnostic studies showed diffuse motor and sensory dysfunction in all extremities; a diagnosis of CIDP was consequently made. Imaging studies showed a large left lobe liver mass. Subsequent biopsy revealed histopathological findings characteristic of hepatocellular carcinoma. After failure of medical treatment with intravenous immunoglobulin and corticosteroids, laparoscopic resection of the tumour was planned, performed and resulted in complete resolution of symptoms. At 18 months postoperatively, the patient was asymptomatic.
副肿瘤综合征是由肿瘤引发的罕见异常内分泌或免疫反应。慢性炎症性脱髓鞘性多发性神经病（CIDP）就是一个例子。CIDP 是一种获得性、免疫介导的周围神经病，影响外周神经和神经根。它与许多类型的癌症有关，特别是血液系统恶性肿瘤。我们报告了一例 60 多岁男性的病例，他因急性上、下肢无力和脚趾及手指末端感觉减退而到急诊科就诊。实验室检查正常。电诊断研究显示所有四肢均有弥漫性运动和感觉功能障碍；因此诊断为 CIDP。影像学研究显示左叶肝有一个大肿块。随后的活检显示出肝细胞癌的特征性组织病理学发现。静脉注射免疫球蛋白和皮质类固醇治疗失败后，计划进行腹腔镜肿瘤切除术，手术成功并使症状完全缓解。术后 18 个月，患者无症状。
