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因副肿瘤性神经综合征而诊断出的小肠神经内分泌癌。

Neuroendocrine carcinoma of the small intestine diagnosed as a result of paraneoplastic neurological syndrome.

作者信息

Nakazawa Kei, Hirata Yuki, Kakimoto Kazuki, Miyazaki Takako, Ota Shin, Hamamoto Hiroki, Ishida Mitsuaki, Nakamura Shiro, Nishikawa Hiroki

机构信息

2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka, Japan.

4th Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.

出版信息

Clin J Gastroenterol. 2023 Oct;16(5):663-667. doi: 10.1007/s12328-023-01822-w. Epub 2023 Jul 11.

Abstract

Paraneoplastic neurological syndromes, a diverse group of neurological syndromes, are associated with small cell lung, testicular, ovarian, and breast cancers; however, their association with neuroendocrine carcinoma of the small intestine remains unreported. In this report, we present the case of a 78-year-old man diagnosed with neuroendocrine carcinoma of the small intestine and experienced symptoms such as subacute progressive numbness of the extremities and impaired gait. These symptoms were diagnosed as tumor-associated neurological syndrome. The patient had also undergone pyloric gastrectomy for early-stage gastric cancer several years prior to the appearance of the neurological symptoms. Therefore, we could not determine whether the tumor-related neurologic syndrome was owing to gastric cancer or neuroendocrine carcinoma of the small intestine; however, one of these conditions was the cause of the neuropathy. The gait disturbance and numbness relatively improved after surgery for the neuroendocrine carcinoma of the small intestine, suggesting that the neuroendocrine carcinoma of the small intestine likely caused the paraneoplastic neurological syndrome. Collectively, we present a unique report highlighting the putative relationship between small bowel neuroendocrine carcinoma and tumor-associated neurologic syndromes.

摘要

副肿瘤性神经综合征是一组多样的神经综合征,与小细胞肺癌、睾丸癌、卵巢癌和乳腺癌相关;然而,它们与小肠神经内分泌癌的关联尚未见报道。在本报告中,我们介绍了一名78岁男性的病例,该患者被诊断为小肠神经内分泌癌,并出现了四肢亚急性进行性麻木和步态障碍等症状。这些症状被诊断为肿瘤相关性神经综合征。该患者在出现神经症状的数年前还因早期胃癌接受了幽门切除术。因此,我们无法确定肿瘤相关神经综合征是由胃癌还是小肠神经内分泌癌引起的;然而,其中一种情况是神经病变的原因。小肠神经内分泌癌手术后,步态障碍和麻木相对有所改善,提示小肠神经内分泌癌可能导致了副肿瘤性神经综合征。我们共同呈现了一份独特的报告,突出了小肠神经内分泌癌与肿瘤相关神经综合征之间的假定关系。

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