PDF(Pubmed)
Abstract：
BACKGROUND: Paraneoplastic neurological syndrome (PNS) is a rare complication in patients with cancer. PNS can affect the central, peripheral, autonomic nervous system, neuromuscular junction, or muscles and cause various neurological symptoms. Anti-Yo antibody-positive neurological paraneoplasms and anti-Hu antibody-positive neurological paraneoplasms are common, but coexistence of both types has not been described in the literature.
METHODS: Here we present a rare case of paraneoplastic neuropathy occurring in both breast and lung cancers. A 55-year-old woman was admitted to our hospital with unsteadiness while walking. The patient had a history of breast cancer two years previously. Chest computed tomography revealed a 4.6 cm × 3.6 cm mass in the right lung, which was diagnosed as small-cell lung cancer (SCLC). Blood test was positive for anti-Yo antibodies, and the cerebrospinal fluid was positive for both anti-Yo and anti-Hu antibodies, and the neurological symptoms were considered to be related to the paraneoplasm. The patient was treated with a course of intravenous immunoglobulin, without noticeable improvement. After being discharged from hospital, the patient underwent regular chemotherapy for SCLC and periodic reviews. The patient\'s neurological symptoms continued to deteriorate at the follow-up visit in April 2021.
CONCLUSIONS: This case suggests the possibility of two types of tumors appearing simultaneously with two paraneoplastic antibodies. The clinical appearance of two or more paraneoplastic tumors requires additional attention.
METHODS: Here we present a rare case of paraneoplastic neuropathy occurring in both breast and lung cancers. A 55-year-old woman was admitted to our hospital with unsteadiness while walking. The patient had a history of breast cancer two years previously. Chest computed tomography revealed a 4.6 cm × 3.6 cm mass in the right lung, which was diagnosed as small-cell lung cancer (SCLC). Blood test was positive for anti-Yo antibodies, and the cerebrospinal fluid was positive for both anti-Yo and anti-Hu antibodies, and the neurological symptoms were considered to be related to the paraneoplasm. The patient was treated with a course of intravenous immunoglobulin, without noticeable improvement. After being discharged from hospital, the patient underwent regular chemotherapy for SCLC and periodic reviews. The patient\'s neurological symptoms continued to deteriorate at the follow-up visit in April 2021.
CONCLUSIONS: This case suggests the possibility of two types of tumors appearing simultaneously with two paraneoplastic antibodies. The clinical appearance of two or more paraneoplastic tumors requires additional attention.
摘要：
背景：副肿瘤神经综合征（PNS）是癌症患者的罕见并发症。PNS可以影响中央，外围,自主神经系统,神经肌肉接头，或肌肉并引起各种神经症状。抗Yo抗体阳性的神经副肿瘤和抗Hu抗体阳性的神经副肿瘤是常见的,但是两种类型的共存在文献中没有描述。
方法：这里我们介绍了一例罕见的发生在乳腺癌和肺癌中的副肿瘤神经病变。一名55岁的妇女因走路时不稳定而入院。患者2年前有乳腺癌病史。胸部计算机断层扫描显示右肺有4.6厘米×3.6厘米的肿块，被诊断为小细胞肺癌（SCLC）。验血的抗Yo抗体呈阳性,脑脊液抗Yo抗体和抗Hu抗体均呈阳性，神经系统症状被认为与副瘤有关。患者接受了一个疗程的静脉注射免疫球蛋白，没有明显的改善。出院后,患者接受了SCLC的常规化疗和定期复查.在2021年4月的随访中，患者的神经症状继续恶化。
结论：该病例提示两种类型的肿瘤与两种副肿瘤抗体同时出现的可能性。两种或多种副肿瘤的临床表现需要额外注意。
方法：这里我们介绍了一例罕见的发生在乳腺癌和肺癌中的副肿瘤神经病变。一名55岁的妇女因走路时不稳定而入院。患者2年前有乳腺癌病史。胸部计算机断层扫描显示右肺有4.6厘米×3.6厘米的肿块，被诊断为小细胞肺癌（SCLC）。验血的抗Yo抗体呈阳性,脑脊液抗Yo抗体和抗Hu抗体均呈阳性，神经系统症状被认为与副瘤有关。患者接受了一个疗程的静脉注射免疫球蛋白，没有明显的改善。出院后,患者接受了SCLC的常规化疗和定期复查.在2021年4月的随访中，患者的神经症状继续恶化。
结论：该病例提示两种类型的肿瘤与两种副肿瘤抗体同时出现的可能性。两种或多种副肿瘤的临床表现需要额外注意。
