Lambert–Eaton myasthenic syndrome revealed after surgery of lung adenocarcinoma

Abstract

We report a very rare case of cT1N0M0 lung adenocarcinoma reveling Lambert-Eaton myasthenic syndrome (LEMS). A 69-year-old nonsmoking woman, with several comorbidities consulted for cough and dyspnea. Chest radiograph and CT scanning detected a left lower lobe mass; Needle biopsy confirmed differentiated adenocarcinoma; 18FDG-PET scan and Brain MRI eliminated metastatic disease dissemination. Our patient underwent a left lower lobectomy with mediastinal lymphadenectomy (pT1N0M0), no adjuvant chemotherapy was administrated. One month later patient present a muscle weakness in both lower limbs and fatigability followed by an inability to walk. The diagnosis of LEMS was made from the distinctive electromyogram (EMG) findings and a treatment with Amifampridine (3, 4-diaminopyridine phosphate [3, 4-DAP]) was prescribed with evident efficacy for symptoms.

Unusual paraneoplastic syndromes in pancreatic cancer: a case report of Lambert-Eaton myasthenic syndrome (LEMS) associated with intraductal papillary mucinous cancer of the pancreas

“…There are no published reports regarding such neurological disorder associated with pancreatic adenocarcinomas in the current literature. Available literature reports pancreatic cancer in association with a general PNS (deep vein thrombosis, coagulation disorders, hypercalcemia, acromegaly, and Cushing syndrome) ( 6 ) and a pancreatic NET inducing neurological PNS ( 7 - 11 ) such as optic neuropathy (positive anti-optic nerve antibodies ( 8 , 9 , 12 ), encephalitis (positive GAD7 and anti-LG1 antibodies) ( 6 , 7 ), myasthenia-like presentation (antibody testing not performed) ( 13 , 14 ). This report is the first description of an adenocarcinoma of the pancreas, that was associated with paraneoplastic LEMs.…”