Hamada Toru, Inoue Koji, Watanabe Masashi, Nakanishi Norihiko
Department of Respiratory Medicine, Ehime Prefectural Central Hospital, Matsuyama city, Ehime, JPN.
Department of Neurology, Ehime Prefectural Central Hospital, Matsuyama city, Ehime, JPN.
Cureus. 2025 Feb 19;17(2):e79272. doi: 10.7759/cureus.79272. eCollection 2025 Feb.
Paraneoplastic neurologic syndrome (PNS) is an association of various cancer types and is reported to occur in small-cell lung cancers (SCLC). It is a nervous disturbance caused by immune-mediated mechanisms with various neurological symptoms. Immune checkpoint inhibitors (ICIs) are increasingly being used to treat SCLC. We report the case of a 69-year-old woman with SCLC complicated by PNS who experienced worsening neurological symptoms (Sensory disturbance, sensory ataxia, and autonomic symptoms) after receiving atezolizumab. The patient's neurological symptoms partially improved after the immunological treatment. Her neurological symptoms did not worsen and her lung cancer remained stable. We believe that ICIs will be increasingly used in the future for SCLC and that we will encounter more cases of PNS that may merge with SCLC deteriorating after receiving ICIs. We describe one case and review the clinical characteristics of patients with SCLC whose PNS was exacerbated by ICIs, including patients with SCLC whose PNS were present prior to the initiation of ICIs. We suggest that neurological symptoms suggestive of PNS should be carefully monitored after the introduction of ICIs for SCLC.
副肿瘤性神经综合征（PNS）与多种癌症类型相关，据报道在小细胞肺癌（SCLC）中会出现。它是一种由免疫介导机制引起的伴有各种神经症状的神经紊乱。免疫检查点抑制剂（ICIs）越来越多地用于治疗SCLC。我们报告了一例69岁患有SCLC并伴有PNS的女性病例，该患者在接受阿替利珠单抗治疗后出现神经症状恶化（感觉障碍、感觉性共济失调和自主神经症状）。经过免疫治疗后，患者的神经症状部分改善。她的神经症状没有恶化，肺癌病情保持稳定。我们认为，未来ICIs将越来越多地用于SCLC的治疗，并且我们将会遇到更多PNS合并SCLC在接受ICIs治疗后病情恶化的病例。我们描述了一例病例，并回顾了PNS因ICIs而加重的SCLC患者的临床特征，包括在开始使用ICIs之前就已存在PNS的SCLC患者。我们建议，在对SCLC使用ICIs后，应仔细监测提示PNS的神经症状。
