A Case of Extreme Gastroparesis due to an Occult Small Cell Cancer of the Lung

Burger, Jan A.; Liberov, Boris; Yurd, F.; Loffeld, R. J. L. F.

doi:10.1155/2013/182962

Cited by 3 publications

(2 citation statements)

References 10 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…identified symptoms of early satiety, diarrhoea, and constipation in cachectic cancer patients that could be secondary to disturbed gastrointestinal (GI) motility, a process intricately linked to proper intestinal smooth muscle function 10 . Moreover, several studies have described GI‐motility disorders such as gastroparesis in patients with malignancies that are frequently accompanied by cachexia 11–15 …”

Section: Introductionmentioning

confidence: 99%

“…10 Moreover, several studies have described GI-motility disorders such as gastroparesis in patients with malignancies that are frequently accompanied by cachexia. [11][12][13][14][15] The musculature of the GI wall consists of an inner circular and an outer longitudinal smooth muscle layer, which are both important for the contractile functionality of the GI tract. 16 Whereas both skeletal and smooth muscles generate contractile forces by actin-myosin crossbridge interactions between sliding filaments, the contractile apparatus of smooth muscle cells (SMCs) consists of SMC-specific actin and myosin isoforms complemented with SMC-specific contractile proteins such as smoothelin.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intestinal smooth muscle aberrations in pancreatic cancer patients with sarcopenia

Vaes

Welbers

Dijk

et al. 2021

JCSM Rapid Communications

View full text Add to dashboard Cite

Background Cancer cachexia is characterized by impaired function of skeletal and cardiac muscle. Smooth muscle is abundantly present in the body and critical for the function of the gastrointestinal tract. Given the frequently reported gastrointestinal symptoms in cancer patients, we hypothesized that the smooth musculature could be compromised in cancer patients with sarcopenia. Methods Full-thickness jejunal tissue sections from 57 pancreatic cancer patients were analysed by picrosirius red stains and immunohistochemistry for α-smooth muscle actin (α-SMA), smoothelin, and CD117 (c-kit). Muscle wall thickness, contractile marker expression, and collagen deposition were quantified. Patients were assigned to a sarcopenia or non-sarcopenia group based on their skeletal muscle index. Results Intestinal smooth muscle wall thickness did not differ between the sarcopenia and non-sarcopenia group (1,661 ± 125.0 vs. 1,439 ± 93.5 μm, P = 0.41). Whereas α-SMA staining intensity was similar in both groups, staining intensity of smoothelin, a key marker of the contractile smooth muscle cell phenotype, was reduced (143.0 ± 22.6 vs. 125.4 ± 29.3 arbitrary units, P = 0.02) in sarcopenic patients. The distribution of CD117 + interstitial cells of Cajal was similar in both groups, but pronounced collagen deposition around the myenteric plexus was more often observed in patients with sarcopenia (P = 0.04). Conclusions These data suggest that cancer cachexia is not only associated with skeletal and cardiac muscle wasting, but also affects the intestinal smooth musculature. Reduced contractile smooth muscle marker expression and fibrosis around the myenteric plexus suggest that both contractile function of smooth muscle cells and regulation of their contractile functionality could be compromised.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intestinal smooth muscle aberrations in pancreatic cancer patients with sarcopenia

Vaes

Welbers

Dijk

et al. 2021

JCSM Rapid Communications

View full text Add to dashboard Cite

show abstract

Paraneoplastic vs. non-paraneoplastic anti-Hu associated dysmotility: a case series and literature review

et al. 2021

View full text Add to dashboard Cite

Occult Non-small Cell Lung Cancer Presenting as Paraneoplastic Gastroparesis: A Case Report and Literature Review

Baig

Randhawa

Majeed

et al. 2019

Cureus

View full text Add to dashboard Cite

Paraneoplastic gastrointestinal syndromes rarely precede the actual detection of an overt cancer with gastroparesis being a very rare initial presentation. To increase the clinical awareness of this rare clinical entity, we present a case of severe gastroparesis that was later proven to be associated with an occult poorly differentiated non-small cell lung cancer. We then continue to briefly review the relevant literature on paraneoplastic gastrointestinal syndromes to date. A 61-year-old African-American man presented with two months history of severe post-prandial nausea, vomiting and bloating associated with unintentional weight loss of 20 pounds. General physical examination revealed cachexia, temporal muscle wasting and clubbing of nails in both hands. The following investigations were normal or negative: basic metabolic panel, liver function tests, chest X-ray and esophagogastroduodenoscopy. Computed tomography (CT) scan of the abdomen showed residual food in the stomach and scintigraphic gastric emptying studies were consistent with gastroparesis. CT scan of the chest was performed which revealed a spiculated nodule sized 9 mm in right upper lobe of the lung with right hilar lymphadenopathy. Positron emission tomography (PET) scan revealed hyper-metabolic activity in the right upper lobe nodule and right hilar adenopathy. Nodule resection and biopsy revealed a poorly differentiated non-small cell lung carcinoma. Due to the concern of paraneoplastic origin of his gastroparesis further serological testing showed positive anti-neuronal nuclear antibodies type 1 (Anti-Hu) and cytoplasmic purkinje cell antibodies (Anti-Yo). The patient was started on a chemotherapy combination of Carboplatin and Paclitaxel with a three-week course of local radiation therapy. Moreover, for the relief of his severe gastrointestinal (GI) symptoms dietary modifications, pro-kinetic agents and psychological counseling were used with gradual clinical improvement observed on follow-up visits.

show abstract

A Case of Extreme Gastroparesis due to an Occult Small Cell Cancer of the Lung

Abstract: A patient with gastroparesis is presented. Ultimately the diagnosis of paraneoplastic gastroparesis due to an occult small cell cancer of the lung was made. The difficulties in the diagnostic process and the pathogenesis of this very rare manifestation are discussed.

Cited by 3 publications

References 10 publications

Intestinal smooth muscle aberrations in pancreatic cancer patients with sarcopenia

Intestinal smooth muscle aberrations in pancreatic cancer patients with sarcopenia

Paraneoplastic vs. non-paraneoplastic anti-Hu associated dysmotility: a case series and literature review

Occult Non-small Cell Lung Cancer Presenting as Paraneoplastic Gastroparesis: A Case Report and Literature Review

Contact Info

Product

Resources

About