A Diagnostic and Management Dilemma

Abstract

To our knowledge, this is the first report of overlap myasthenic syndrome in conjunction with abdominal leiomyosarcoma. The immunologic coexistence of acquired myasthenia gravis and Lambert-Eaton myasthenic syndrome in a patient with a malignant smooth-muscle tumor is intriguing and suggests that a common paraneoplastic process targeting 2 different onconeural antigens was the underlying pathogenic mechanism in this patient.

Lambert-Eaton Myasthenic Syndrome Associated with Synchronous Double Cancer: A Combination of Small Cell Carcinoma of the Cervix and Breast Carcinoma

“…Indeed, only one case of recurrent paratracheal and hilar lymphadenopathy for LEMS associated with small cell carcinoma in the uterus was reported ( 4 ). Other gynecological or breast tumors with LEMS were uterine leiomyosarcoma ( 5 ), intravascular uterine leiomyoma ( 6 ) and breast carcinoma ( 7 ). The pathological diagnosis of breast carcinoma in this case was invasive lobular carcinoma (namely, adenocarcinoma), which is quite different from small cell carcinoma.…”

Lambert-Eaton myasthenic syndrome as a cause of persistent neuromuscular weakness after a mediastinoscopic biopsy -A case report-

“…However, 3,4-diaminopyridine was not available at our hospital. Sometimes, LEMS can be combined with myasthenia gravis (overlap myasthenic syndrome) and one patient with this combination responded favorably to treatment with prednisone and anticholinesterase agents [11]. Therefore, we gave our patient anticholinesterase, but there was no improvement in his neuromuscular functions.…”