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Abstract：
A 69-year-old woman presented with 9 months history of progressively worsening upper and lower limb weakness leading to reduced functional status. She was diagnosed with peripheral neuropathy (predominantly sensory) initially and had received immunoglobulins and pulsed steroid therapy with no benefit. She was following up with respiratory team for surveillance of hamartoma in left lower lobe. Investigations included a battery of serum samples and tissue samples on two different occasions. Anti-HU and anti-CV2 antibodies were found positive in serum. Sural nerve biopsy raised suspicion of paraneoplastic phenomenon. CT thorax abdomen and pelvis was carried out to identify a primary neoplastic source; however no lesion was identified except for the previously documented hamartoma in the left lower lobe. Positron emission tomography (PET) scan was carried out that identified a single fluorodeoxyglucose (FDG)-avid focus either in the mid oesophagus or in the left para oesophageal region below the left main bronchus. Gastroscopy showed evidence of inflammation only. Bronchoscopy/endobronchial ultrasound (EBUS)-guided lymph node biopsy turned out be small cell lung carcinoma on histological analysis. She was then referred to oncology services, and received 4 cycles of carboplatin/etoposide chemotherapy followed by 30 fractions of radiotherapy. She finished chemotherapeutic treatment without any complications. So far her symptoms have not settled, but not worsening anymore and she continues physiotherapy to regain limb function.
摘要：
一名69岁的女性，有9个月的上肢和下肢无力逐渐恶化导致功能状态降低的病史。她最初被诊断为周围神经病变（主要是感觉），并接受了免疫球蛋白和脉冲类固醇治疗，但没有任何益处。她正在与呼吸小组跟进监测左下叶错构瘤。调查包括在两种不同情况下的一系列血清样本和组织样本。血清中发现抗HU和抗CV2抗体呈阳性。腓肠神经活检怀疑副肿瘤现象。进行了胸部腹部和骨盆的CT检查以确定原发性肿瘤来源；但是，除了先前记录的左下叶错构瘤外，没有发现任何病变。进行了正电子发射断层扫描（PET）扫描，确定了食管中部或左主支气管下方的左食管旁区域的单个氟代脱氧葡萄糖（FDG）-焦点。胃镜检查仅显示炎症的证据。支气管镜/支气管超声（EBUS）引导下淋巴结活检证实为小细胞肺癌的组织学分析。然后她被转介到肿瘤科，并接受了4个周期的卡铂/依托泊苷化疗，然后进行30次放疗。她完成了化疗治疗，没有任何并发症。到目前为止她的症状还没有解决,但不再恶化，她继续进行理疗以恢复肢体功能。
