Neuromyelitis optica spectrum disorder (NMOSD) associated with cancer: A systematic review

Shahmohammadi, Sareh; Doosti, Rozita; Shahmohammadi, Abootorab; Azimi, Amirreza; Sahraian, Mohammad Ali; Fattahi, Mohammad Reza; Moghadasi, Abdorreza Naser

doi:10.1016/j.msard.2021.103227

Cited by 25 publications

(35 citation statements)

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“…Clinical signs of NMOSD in elderly patients, especially of subacute onset, should arouse the suspicion of paraneoplastic etiology ( 16 ). Indeed, several cancers are known to be associated with NMOSD.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, several cancers are known to be associated with NMOSD. In 2021, Shahmohammadi et al performed a comprehensive literature search for all types of cancers associated with NMOSD ( 16 ). The authors described 62 cases that met the Paraneoplastic Neurologic Syndromes (PNS) Euro network criteria ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

“…Our findings increase the recognition that AQP4-antibody-positive NMOSD, especially in elderly patients, should suggest the presence of underlying cancer. Lung adenocarcinoma is not one of the most frequently occurring cancers in paraneoplastic NMOSD cases and very often the neoplasm is already advanced at the moment of diagnosis ( 16 ). In lung adenocarcinoma, despite many other tumors, NMOSD symptoms usually precede cancer diagnosis ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

“…Lung adenocarcinoma is not one of the most frequently occurring cancers in paraneoplastic NMOSD cases and very often the neoplasm is already advanced at the moment of diagnosis ( 16 ). In lung adenocarcinoma, despite many other tumors, NMOSD symptoms usually precede cancer diagnosis ( 16 ). We believe our case is particularly interesting because of the extremely rapid clinical deterioration thus underlying the importance of a rapid diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…comprehensive literature search for all types of cancers associated with NMOSD (16). The authors described 62 cases that met the Paraneoplastic Neurologic Syndromes (PNS) Euro network criteria (17).…”

Section: Discussionmentioning

confidence: 99%

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Paraneoplastic Neuromyelitis Optica Spectrum Disorder Associated With Lung Adenocarcinoma: A Case Report

et al. 2022

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Neuromyelitis Optica spectrum disorder is an inflammatory demyelinating disease affecting the central nervous system (CNS), characterized by triad optic neuritis, transverse myelitis, and area postrema syndrome. Antibodies directed against aquaporin-4 (AQP-4), a water channel expressed on the astrocytic membrane, are supposed to play a pathogenic role and are detected in ~80% of cases. Clinical signs of Neuromyelitis Optica spectrum disorder (NMOSD) in elderly patients should arouse the suspicion of paraneoplastic etiology. In this article, we discussed a case of a 76-year-old woman with a 2-month history of confusion, dysarthria, and progressive bilateral leg weakness. A whole-body CT scan showed a neoformation of 5 cm in diameter in the median lobe infiltrating the mediastinal pleura. The tumor had already spread to both the upper and lower right lobes, parietal pleura, and multiple lymph nodes. Pleural cytology revealed adenocarcinoma cells. The brain MRI documented hyperintense alteration in fluid-attenuated inversion recovery (FLAIR) images, involving the anterior portion of the corpus callosum and the periependymal white matter surrounding the lateral ventricles, with mild contrast enhancement on the same areas and meningeal tissue. T2-weighted spinal cord MRI sequences showed extended signal hyperintensity from bulbo-cervical junction to D7 metamer, mainly interesting the central component and the gray matter. Cerebrospinal fluid analysis revealed no neoplastic cells. Serum AQP-4 immunoglobulin (IgG) antibodies were found. Meanwhile, the patient rapidly developed progressive paraparesis and decreased level of consciousness. High-dose intravenous methylprednisolone therapy was started but her conditions rapidly deteriorated. No other treatment was possible.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%