Xu Chaowei, Wu Hanfan, Chen Jian
Department of Neurology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China.
Department of Electro Neurophysiology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China.
Front Neurol. 2024 Feb 12;15:1325318. doi: 10.3389/fneur.2024.1325318. eCollection 2024.
Paraneoplastic lower motor neuronopathies (LMNs) have rarely been reported with malignant liver tumors. A 71-year-old man developed chronic progressive upper limb and cranial nerve paralysis. Electromyography examination suggests chronic progressive neuronal damage involving the right C4-T1 nerve root innervated muscle and the right sternocleidomastoid muscle. Magnetic resonance imaging suggested the presence of a malignant liver tumor. His serum was positive for anti-Yo antibodies. Hepatic artery chemoembolization was performed, followed by treatment with pembrolizumab and lenvatinib. The patient's condition improved, and paraneoplastic LMNs were diagnosed. Paraneoplastic causes should be considered in the differential diagnosis of chronic progressive LMNs. A combination of surgical treatment and immunotherapy may result in a favorable outcome.
副肿瘤性下运动神经元病（LMNs）与恶性肝肿瘤相关的报道极为罕见。一名71岁男性出现慢性进行性上肢和颅神经麻痹。肌电图检查提示慢性进行性神经元损伤，累及右侧C4 - T1神经根支配的肌肉及右侧胸锁乳突肌。磁共振成像显示存在恶性肝肿瘤。其血清抗Yo抗体呈阳性。进行了肝动脉化疗栓塞，随后使用帕博利珠单抗和乐伐替尼治疗。患者病情改善，诊断为副肿瘤性LMNs。在慢性进行性LMNs的鉴别诊断中应考虑副肿瘤性病因。手术治疗与免疫治疗相结合可能会带来良好的效果。
