Sub-Acute Sensory Neuronopathy As a Preceding Sign of Recurrence In Colon Carcinoma

Abstract

Subacute sensory neuronopathy is a paraneoplastic syndrome, which occurs mostly in lung, breast, ovarian malignancies and lymphoma. A 75-yr-old woman who was at the twentieth month of her postoperative follow-up owing to colon adenocarcinoma admitted with subacute sensory neuronopathy. Six months later from the first, neuropathic symptoms liver metastases developed. To the best of our literature review subacute sensory neuronopathy as a preceding sign of recurrence in colon adenocarcinoma has not previously been reported. We conclude that, in the case of subacute sensory neuronopathy without an obvious underlying etiological factor, an occult malignity should always be researched in clinical practice.

Multimodal quantitative examination of nerve function in colorectal cancer patients prior to chemotherapy

“…Importantly, the description of peripheral nerve pathology with colorectal cancer, related to the underlying disease rather than the treatment, is limited to few case reports of both axonal and demyelinating neuropathies. 13,14,37 Our results from comprehensive baseline neurological evaluation of patients with colorectal cancer, including both subjective and objective measures, are comparable to findings in normal controls or with population-based norms, suggesting a low likelihood of significant peripheral neuropathy in this cohort before initiation of chemotherapy. Accordingly, in a patient with colorectal cancer and clinical evidence of peripheral neuropathy before chemotherapy, it is important to assess for other, potentially treatable causes of neuropathy.…”

“…However, paraneoplastic peripheral neuropathy is uncommon and a mechanism for peripheral neuropathy in the majority of patients with solid tumors has not been elucidated. Importantly, the description of peripheral nerve pathology with colorectal cancer, related to the underlying disease rather than the treatment, is limited to few case reports of both axonal and demyelinating neuropathies …”

Neurological Manifestation of Colonic Adenocarcinoma

“…A Turkish group reported a patient with subacute sensory neuronopathy as a preceding sign of colonic cancer recurrence. 8 In another case, sensorimotor neuropathy and axonopathy were found in a patient with sigmoid cancer. 4 The patient's neurologic symptoms resolved upon removal of the sigmoid colon, suggesting a strong paraneoplastic origin similar to our case.…”

Pain as a First Manifestation of Paraneoplastic Neuropathies: A Systematic Review and Meta-Analysis

“…PNS can be the first manifestation of cancer relapse [ 8 , 17 , 20 ] and they often precede the clinical or radiological diagnosis of a local relapse or distant metastases. Patients with a history of cancer presenting with peripheral neuropathic pain, not otherwise explained, can be diagnosed with PNS when circulating paraneoplastic antibodies are detected or a PET scan is positive.…”