A 44-year-old woman with diarrhoea and double vision

Arruda, Walter Oleschko; Rosa, José F.T. da

doi:10.1016/s0140-6736(97)04392-4

Cited by 3 publications

(1 citation statement)

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“…In small-cell lung cancer, PNPS is most frequently linked to lung cancer, with LEMS being the most prevalent PNS in the neuromuscular junction. When limiting the search time to 1990 to 2022, the search terms to "Lung Neoplasms" or "Adenocarcinoma of Lung" AND "myasthenia gravis" in Pubmed, most of the published cases are reports of other lung tumors complicated with MG, [10][11][12][13][14][15][16][17][18][19][20][21] but only 3 cases of lung adenocarcinoma [22][23][24] (Table 1). A thorough assessment of the literature led us to conclude that the causes of the coexistence of the 2 components have steadily become better understood over time, moving from an accidental phenomenon to an immunological problem to a paraneoplastic manifestation.…”

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confidence: 99%

Myasthenia-like paraneoplastic syndrome with multiple cranial nerve tumor infiltration: A case report and literature review

Cheng

Yang

et al. 2023

Medicine

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Rationale: Approximately 0.001% of patients with cancer have paraneoplastic nerve system syndrome, which can affect the central nervous system, neuromuscular junction, or peripheral nervous system. Although myasthenia gravis (MG) may exist as a thymic paraneoplastic syndrome (PNPS), its association with primary lung cancer remains unknown.Patient concerns: A 55-year-old female presented with slurred speech, weakness in chewing, sporadic difficulty in swallowing, and weakness in both lower limbs for half a year.Diagnoses: Based on cerebrospinal fluid and electromyography findings, we present the case of a female patient diagnosed with overlapping multicranial nerve tumor infiltration and MG-like neurological PNPS secondary to lung adenocarcinoma. Interventions:The patient received intrathecal injections of pemetrexed and neurotrophic (vitamin B) therapy before ceasing chemoradiotherapy and chose cabozantinib on her own.Outcomes: Weakness of the proximal limbs, choking cough, and chewing problems did not improve significantly.Lessons: Although it is unclear why MG coexists with lung cancer, it is probable that MG is a paraneoplastic condition. Cerebrospinal fluid testing should be carried out along with electrophysiological, serological, and pharmacological procedures pertinent to the diagnosis of MG to thoroughly examine if people simultaneously experience MG-like PNPS and tumor growth. Starting immunotherapy and anticancer medication at the same time that tumor development and MG-like syndrome are discovered is crucial.

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