Paraneoplastic Limbic Encephalitis in a Male with Squamous Cell Carcinoma of the Lung
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background Paraneoplastic limbic encephalitis (PLE) is a rare syndrome characterized bymemory impairment, symptoms of hypothalamic dysfunction, and seizures. It commonly precedes the diagnosis of cancer. Small-cell lung cancer is the neoplasm that is most frequently reported as the etiology underlying PLE. Case Report This report describes a male patient who presented with neurologic symptomsconsistent with anterograde amnesia, apathy, and disorientation. MRI revealed diffuse hyperintensities located predominantly in the medial bitemporal lobes, basal ganglia, frontal lobes, andleptomeninges on fluid attenuated inversion recovery images, suggesting PLE. Study of the primary tumor revealed squamous cell carcinoma of the lung. The patient was treated with neoadjuvant chemotherapy followed by surgery and adjuvant chemoradiotherapy, which resulted in hisneurologic symptoms gradually improving. Conclusions PLE might be a rare debut of squamous cell carcinoma of the lung. Treatment ofthe primary tumor may improve the neurologic symptoms.
Abstract
Background Paraneoplastic limbic encephalitis (PLE) is a rare syndrome characterized bymemory impairment, symptoms of hypothalamic dysfunction, and seizures. It commonly precedes the diagnosis of cancer. Small-cell lung cancer is the neoplasm that is most frequently reported as the etiology underlying PLE. Case Report This report describes a male patient who presented with neurologic symptomsconsistent with anterograde amnesia, apathy, and disorientation. MRI revealed diffuse hyperintensities located predominantly in the medial bitemporal lobes, basal ganglia, frontal lobes, andleptomeninges on fluid attenuated inversion recovery images, suggesting PLE. Study of the primary tumor revealed squamous cell carcinoma of the lung. The patient was treated with neoadjuvant chemotherapy followed by surgery and adjuvant chemoradiotherapy, which resulted in hisneurologic symptoms gradually improving. Conclusions PLE might be a rare debut of squamous cell carcinoma of the lung. Treatment ofthe primary tumor may improve the neurologic symptoms.
참고문헌 (17)
- Graus F, "Recommended diagnostic criteria for paraneoplastic neurological syndromes", J Neurol Neurosurg Psychiatry, 75, pp.1135~1140 (2004)
- Bataller L, "Autoimmune limbic encephalitis in 39 patients: immunophenotypes and outcomes", J Neurol Neurosurg Psychiatry, 78, pp.381~385 (2007)
- Dropcho EJ, "Update on paraneoplastic syndromes", Curr Opin Neurol, 18, pp.331~336 (2005)
- Dirr LY, "Evolution of brain MRI abnormalities in limbic encephalitis", Neurology, 40, pp.1304~1306 (1990)
- Lawn ND, "Clinical, magnetic resonance imaging, and electroencephalographic findings in paraneoplastic limbic encephalitis", Mayo Clin Proc, 78, pp.1363~1368 (2003)
- Brierley JB, "Subacute encephalitis of later adult life. Mainly affecting the limbic areas", Brain, 83, pp.357~368 (1960)
- Corsellis JA, "“Limbic encephalitis” and its association with carcinoma", Brain, 91, pp.481~496 (1968)
- Burton GV, "Paraneoplastic limbic encephalopathy with testicular carcinoma. A reversible neurologic syndrome", Cancer, 62, pp.2248~2251 (1988)
- Dögel D, "Paraneoplastic limbic encephalitis resulting from non-Hodgkin-lymphoma: two case reports", Fortschr Neurol Psychiatr, 76, pp.41~46 (2008)
- Alamowitch S, "Limbic encephalitis and small cell lung cancer. Clinical and immunological features", Brain, 120(6), pp.923~928 (1997)
- Rajappa S, "Primary renal lymphoma presenting with paraneoplastic limbic encephalitis", J Clin Oncol, 25, pp.3783~3785 (2007)
- Howe MC, "Neuroendocrine differentiation in non-small cell lung cancer and its relation to prognosis and therapy", Histopathology, 46, pp.195~201 (2005)
- Dabbeche C, "Paraneoplastic limbic encephalitis associated with epidermoid lung carcinoma", J Neuroradiol, 32, pp.278~280 (2005)
- Voltz R, "Paraneoplastic neurological syndromes: an update on diagnosis, pathogenesis, and therapy", Lancet Neurol, 1, pp.294~305 (2002)
- Gultekin SH, "Paraneoplastic limbic encephalitis: neurological symptoms, immunological findings and tumour association in 50 patients", Brain, 123(7), pp.1481~1494 (2000)
- Schüller M, "The human PNMA family: novel neuronal proteins implicated in paraneoplastic neurological disease", J Neuroimmunol, 169, pp.172~176 (2005)
- Darnell RB, "Paraneoplastic syndromes involving the nervous system", N Engl J Med, 349, pp.1543~1554 (2003)