Spontaneous Regression of Small Cell Carcinoma of Lung Associated with Severe Neuropathy

Zaheer, Wajih; Friedland, Michael; Cooper, Everett B.; DoRosario, Arnold; Burd, Robert M.; Gagliardi, Joseph A.; Torstenson, Guy

doi:10.3109/07357909309024856

Cited by 29 publications

(15 citation statements)

References 8 publications

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“…However, most patients have an unsatisfactory course with these therapies, especially in PSN, and the successful rate is reported to be only about 10% [4]. Even in SR cases, the complete improvement is rarely observed and in some cases, PSN is reported to be progressive even after the tumor disappeared [11,12]. In our case, although SR of tumor was obtained for first 1 month, PSN has been progressive during that period.…”

Section: Discussioncontrasting

confidence: 68%

A case of spontaneous regression of small cell lung cancer with progression of paraneoplastic sensory neuropathy

et al. 2007

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Section: Discussioncontrasting

confidence: 68%

A case of spontaneous regression of small cell lung cancer with progression of paraneoplastic sensory neuropathy

et al. 2007

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“…No tumour was detected in eight patients, while in one anti-Hu patient a radiologically suspect lung lesion disappeared spontaneously during the course of PCD. Remissions of radiologically suspect lung lesions and histologically con®rmed SCLC during anti-Hu-associated PEM/SN have been reported previously (Darnell and DeAngelis, 1993;Zaheer et al, 1993) and support an important role for HuD-speci®c cytotoxic T lymphocytes (Benyahia et al, 1999;Plonquet et al, 2002).…”

Section: Discussionmentioning

confidence: 95%

Paraneoplastic cerebellar degeneration associated with antineuronal antibodies: analysis of 50 patients

Shamsili¹,

Grefkens²,

Leeuw³

et al. 2003

Brain

491

391

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SummaryParaneoplastic cerebellar degeneration (PCD) is a heterogeneous group of disorders characterized by subacute cerebellar ataxia, speci®c tumour types and (often) associated antineuronal antibodies. Nine speci®c antineuronal antibodies are associated with PCD. We examined the relative frequency of the antineuronal antibodies associated with PCD and compared the neurological symptoms and signs, associated tumours, disability and survival between groups of PCD with different antibodies. Also, we attempted to identify patient-, tumour-and treatment-related characteristics associated with functional outcome and survival. In a 12-year period, we examined >5000 samples for the presence of antineuronal antibodies. A total of 137 patients were identi®ed with a paraneoplastic neurological syndrome and high titre (b400) antineuronal antibodies. Fifty (36%) of these patients had antibodyassociated PCD, including 19 anti-Yo, 16 anti-Hu, seven anti-Tr, six anti-Ri and two anti-mGluR1. Because of the low number, the anti-mGluR1 patients were excluded from the statistical analysis. While 100% of patients with anti-Yo, anti-Tr and anti-mGluR1 antibodies suffered PCD, 86% of anti-Ri and only 18% of anti-Hu patients had PCD. All patients presented with subacute cerebellar ataxia progressive over weeks to months and stabilized within 6 months. The majority of patients in all antibody groups had both truncal and appendicular ataxia. The frequency of nystagmus and dysarthria was lower in anti-Ri patients (33 and 0%). Later in the course of the disease, involvement of noncerebellar structures occurred most frequently in antiHu patients (94%). In 42 patients (84%), a tumour was detected. The most commonly associated tumours were gynaecological and breast cancer (anti-Yo and anti-Ri), lung cancer (anti-Hu) and Hodgkin's lymphoma (antiTr and anti-mGluR1). In one anti-Hu patient, a suspect lung lesion on CT scan disappeared while the PCD evolved. Seven patients improved by at least 1 point on the Rankin scale, while 16 remained stable and 27 deteriorated. All seven patients that improved received antitumour treatment for their underlying cancer, resulting in complete remission. The functional outcome was best in the anti-Ri patients, with three out of six improving neurologically and ®ve were able to walk at the time of last follow-up or death. Only four out of 19 anti-Yo and four out of 16 anti-Hu patients remained ambulatory. Also, survival from time of diagnosis was signi®cantly worse in the anti-Yo (median 13 months) and anti-Hu (median 7 months) patients compared with anti-Tr (median >113 months) and anti-Ri (median >69 months). Patients receiving antitumour treatment (with or without immunosuppressive therapy) lived signi®-cantly longer [hazard ratio (HR) 0.3; 95% con®dence interval (CI) 0.1±0.6; P = 0.004]. Patients b60 years old lived somewhat shorter from time of diagnosis, although statistically not signi®cant (HR 2.9; CI 1.0±8.5; P = 0.06).

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“…Most PND patients who present with neuronal degenerations are unaware that they harbor an occult malignancy (most commonly breast, ovarian, or small cell lung tumors); in rare instances, malignant neoplasms have been documented to vanish without treatment after the onset of neurologic disease (10,13). Within the nervous system, nearly any group of neurons can be targeted in PND, including those of the limbic system, retina, cerebellum, brainstem, spinal cord, and dorsal root ganglia (Table 1).…”

mentioning

confidence: 99%

Onconeural antigens and the paraneoplastic neurologic disorders: at the intersection of cancer, immunity, and the brain.

Darnell

1996

Proc. Natl. Acad. Sci. U.S.A.

256

132

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Paraneoplastic neurologic disorders (PNDs) are believed to be autoimmune neuronal degenerations that develop in some patients with systemic cancer. A series of genes encoding previously undiscovered neuronal proteins have been cloned using antiserum from PND patients. Identification of these onconeural antigens suggests a reclassification of the disorders into four groups: those in which neuromuscular junction proteins, nerve terminal/vesicleassociated proteins, neuronal RNA binding proteins, or neuronal signal-transduction proteins serve as target antigens. This review considers insights into basic neurobiology, tumor immunology, and autoimmune neuronal degeneration offered by the characterization of the onconeural antigens.

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Spontaneous Regression of Small Cell Carcinoma of Lung Associated with Severe Neuropathy

Abstract: This is a case report of small cell lung cancer (SCLC) that underwent spontaneous regression. This was associated with severe neuropathy, which was unresponsive to therapy, including corticosteroids and plasmapheresis. We present here the case report and a brief review of the literature.

Cited by 29 publications

References 8 publications

A case of spontaneous regression of small cell lung cancer with progression of paraneoplastic sensory neuropathy

A case of spontaneous regression of small cell lung cancer with progression of paraneoplastic sensory neuropathy

Paraneoplastic cerebellar degeneration associated with antineuronal antibodies: analysis of 50 patients

Onconeural antigens and the paraneoplastic neurologic disorders: at the intersection of cancer, immunity, and the brain.

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