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副肿瘤性视乳头炎作为结肠癌的前驱病变:一例因意外视力丧失导致早期癌症检测的病例

Paraneoplastic Papillitis as a Precursor to Colon Carcinoma: A Case of Unexpected Vision Loss Leading to Early Cancer Detection.

作者信息

Takacova Tana, Singh Yashpal, Seidel Adrian, Gübitz Raphael, Takacova Tana, Arnold Dirk

机构信息

Department of Oncology and Hematology, Asklepios Tumorzentrum Hamburg, Asklepios Klinik Altona, Hamburg, Germany.

Department of Neurology, Asklepios Klinik Altona, Hamburg, Germany.

出版信息

Oncol Res Treat. 2025;48(7-8):457-463. doi: 10.1159/000545214. Epub 2025 Mar 21.

Abstract

INTRODUCTION

Paraneoplastic neurological syndromes are rare manifestations of cancer, characterized by autoantibodies targeting neuronal antigens. These syndromes often precede or accompany cancer diagnosis, complicating their interpretation. In this case report, we present the first documented patient with paraneoplastic papillitis causing visual disturbances in association with colorectal adenocarcinoma.

CASE PRESENTATION

A 76-year-old female presented with acute vision loss and difficulty walking. A multidisciplinary team, including an ophthalmologist, neurologist, gastroenterologist, radiologist, and oncologist, collaborated to diagnose early-stage adenocarcinoma of the ascending colon. This diagnosis was triggered by the detection of anti-CV2 and anti-amphiphysin antibodies in cerebrospinal fluid, indicative of PNS.

CONCLUSION

This case underscores the necessity of considering colorectal carcinoma in the differential diagnosis of inflammatory cerebrospinal fluid syndromes and highlights the crucial role of interdisciplinary collaboration in identifying rare paraneoplastic conditions.

摘要

引言

副肿瘤性神经系统综合征是癌症的罕见表现,其特征是针对神经元抗原的自身抗体。这些综合征常常在癌症诊断之前出现或伴随癌症诊断,这使得对它们的解读变得复杂。在本病例报告中,我们介绍了首例有记录的因副肿瘤性视乳头炎导致视力障碍并伴有结肠腺癌的患者。

病例介绍

一名76岁女性出现急性视力丧失和行走困难。一个由眼科医生、神经科医生、胃肠病学家、放射科医生和肿瘤科医生组成的多学科团队共同协作,诊断出升结肠癌早期。脑脊液中抗CV2和抗 amphiphysin抗体的检测引发了这一诊断,提示为副肿瘤性神经系统综合征。

结论

本病例强调了在炎症性脑脊液综合征的鉴别诊断中考虑结肠直肠癌的必要性,并突出了跨学科协作在识别罕见副肿瘤性疾病中的关键作用。

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