Cancer-Associated Retinopathy during Treatment for Small-Cell Lung Carcinoma.

Kashiwabara, Kosuke; Nakamura, Hiroyuki; Kishi, Koji; Yagyu, Hisanaga; Sarashina, Gen; Kobayashi, Katsuyuki; Matsuoka, Takeshi

doi:10.2169/internalmedicine.38.597

Cited by 25 publications

(8 citation statements)

References 23 publications

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“…Usually these antibodies were detected because of severe visual defects observed in patients by ophthalmologists even earlier to the cancer diagnosis. Such a relationship between ocular symptoms and remote cancer is known as a cancer-associated retinopathy (CAR) and is a classical example of paraneoplastic neurological disorders [2,[6][7][8][9]. Postulated mechanism of CAR development assumes that mammalian retinas contain tissuespecific proteins, termed retinal antigens (RAs), which are overexpressed by cancer cells and induce autoimmune response.…”

Section: Introductionmentioning

confidence: 99%

Serum Antibodies to Retinal Antigens in Lung Cancer and Sarcoidosis

et al. 2004

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Objective: Autoantibodies to various neuronal proteins frequently accompany lung cancer and their appearance may precede cancer symptoms. In this study we examined which retinal antigens (RAs) are recognized by sera of patients with lung cancer and whether the occurrence of serum antibodies to particular RAs is characteristic for cancer in comparison with a noncancer lung disease. Methods: Sera of 72 patients with non-small-cell lung cancer (NSCLC), 29 with small-cell lung cancer (SCLC), 27 with sarcoidosis (S), and sera of 32 healthy donors were examined in immunoblotting using retinal extracts and purified RAs as antigens. Results: 69.0% of SCLC, 45.8% of NSCLC, and 44.4% of S sera displayed anti-RAs reactivity. Significantly less (p < 0.05; χ² test) percent of healthy control sera reacted with RAs. Lung cancer sera recognized mainly 46-, 56-, and 36-kD and to a smaller extent also 96-, 72-, 43-, and 26-kD proteins. Most of them were recognized with about 2-fold lower frequencies by S and control sera. Only lung cancer sera contained very high-titer antibodies to 46- and 26-kD RAs, identified as α-enolase and recoverin, respectively. Conclusion: Antibodies to RAs occur more frequently and in higher titers in lung cancer (especially SCLC) than in sarcoidosis or control sera. Although antibodies to retinal α-enolase, recoverin and other RAs are present mainly or exclusively in lung cancer sera, none of them seems to be a specific marker of a particular disease.

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Section: Introductionmentioning

confidence: 99%

Serum Antibodies to Retinal Antigens in Lung Cancer and Sarcoidosis

et al. 2004

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“…CAR syndrome, one form of paraneoplastic syndrome triggered by an autoimmune mechanism, is a degenerative retinopathy that is characterized by the production of an autoantibody to a retinal photoreceptor protein in the retinal cone, recoverin; the leading malignant cause of CAR is SCLC. [7][8][9] Clinical manifestations of CAR syndrome are photosensitivity, ring scotomatous visual loss, and attenuated retinal arteriole caliber.…”

Section: Discussionmentioning

confidence: 99%

Choroidal metastasis in a patient with small cell lung cancer discovered during treatment with chemotherapy

et al. 2009

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A 56-year-old male patient complaining of productive cough, hoarseness, and fatigue was found to have extensive disease of small cell lung cancer (ED-SCLC), with staging of cT4N3M1(PUL). He was treated with chemotherapy. While undergoing treatment with chemotherapy, he complained of a right visual disturbance, and choroidal metastasis was diagnosed. Because the primary site responded well to chemotherapy alone and the visual disturbance did not worsen, the patient refused radiotherapy to the choroidal metastasis. Two months after the first diagnosis of the choroidal metastasis, while he was receiving the first treatment regimen for SCLC, the visual disturbance suddenly worsened; emergent radiotherapy was started, with a total dose of 40 Gy, given as 2.0 Gy/fraction per day. The visual disturbance never improved, and the patient lost 80% of his right visual field. Within 6 months of diagnosis, the patient became blind in his right eye. The patient died of septic shock related to treatment received during his third chemotherapy regimen. Choroidal metastasis is very rare with extraocular malignant tumors, though it is common with intraocular malignant tumors. Choroidal metastasis secondary to SCLC has a poor prognosis, but in order to maintain quality of life during the patients' remaining lifespan, aggressive treatment would appear appropriate for these patients, because SCLC is a chemo-sensitive cancer.

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“…Una de ellas, asociada al carcinoma microcíti-co, es similar a la retinitis pigmentaria; en cambio, la asociada al melanoma es menos conocida y está menos estudiada. La enfermedad neurológica asociada al carcinoma microcítico está muy bien estudiada y se asocia a un número importante de fenómenos neurológicos relacionados con la producción de anticuerpos producidos por el tumor primario, entre los que destacan la cerebelitis, la encefalitis límbica, el síndrome de opsoclonía-mioclonía, el síndrome de la persona rígida (stiff-man) y el síndrome miasténico de Lamber-Eaton, entre otros, con anticuerpos contra el canal del calcio, contra el canal del potasio y contra la recoverina 14,15 . La recoverina es producida de forma anómala por los tumores pulmonares y es la diana que despierta los anticuerpos antirrecoverina que posteriormente bloquean a la recoverina retiniana 16,17 .…”

Section: Discussionunclassified