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Vol.61 No.2 contents | Japanese/English |
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- Case Report -
A Case of Spontaneous Regression of Small-cell Lung Cancer with Paraneoplastic Cerebellar Degeneration
Mineyo Mito1, Takashi Kurashige2, Yoshihiro Kitahara5, Takeshi Mimura3, Kazuya Kuraoka4, Yoshinori Yamashita3, Kikuo Nakano11Department of Respiratory Medicine, 2Department of Neurology, 3Department of General Thoracic Surgery, 4Department of Diagnostic Pathology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Japan, 5Hiroshima City Funairi Citizens Hospital, Japan
Background. The cause of paraneoplastic neurological syndrome (PNS) in about 80% of cases is small-cell lung cancer. However, PNS is difficult to diagnose, and there is no established standard therapy for it. Case. A 78-year-old man was admitted to the hospital with acutely progressive symptoms of cerebellar ataxia. Chest computed tomography performed on his clavicle when he broke it had shown a pulmonary nodule in the right upper lobe and mediastinal lymph node swelling 6 months before the admission, but these nodules had spontaneous regressed by admission. After treating the patient with high dose intravenous immunoglobulin (IVIG), the neurological symptoms improved. However, mediastinal lymph node showed re-swelling. The mediastinal lymph node was diagnosed as metastatic small-cell lung cancer by mediastinoscopy. In addition, anti-voltage gated calcium channel antibody, which is an anti-neural antibody, was positive. Therefore, the patient was diagnosed with paraneoplastic cerebellar degeneration due to small-cell lung cancer. The patient underwent chemoradiation and achieved a complete response, ultimately obtaining a long-term survival. Conclusion. IVIG and chemoradiation for PNS improve the neurological symptoms and prognosis.
key words: Small-cell lung cancer, Paraneoplastic neurological syndrome, Paraneoplastic cerebellar degeneration, Spontaneous regression, High dose intravenous immunoglobulin
Received: October 30, 2020
Accepted: December 9, 2020
JJLC 61 (2): 113-118, 2021
