The carcinomatous neuromyopathy of oat cell lung cancer

Abstract

A prospective controlled clinical-neurophysiological-pathological study of 71 patients with oat cell carcinoma of the lung revealed no increased incidence of peripheral neuropathy at the initial stages of illness. All patients developed neuropathy by the time they had lost 15% of their body weight, but the neuropathy was less severe than in 20 age-matched alcoholic patients with an equal degree of weight loss. The weight loss and peripheral neuropathy progressed with atrophy of type II (adenosine triphosphatase-positive) muscle fibers out of proportion to the patient's loss of body weight. By 40% body weight loss, all the patients had moderate symmetrical peripheral neuropathy, 6 had proximal brachial or lumbosacral plexus metastases, and 9 had distal pressure palsies. Mononeuritis multiplex developed in only 1 patient, who had diabetes mellitus. Two patients developed Eaton-Lambert syndrome, which resolved in 1 when chemotherapy controlled the systemic tumor, with no protein in the tumor postmortem which could produce the characteristic electromyographic findings of the syndrome.

Managing Paraneoplastic Neurological Disorders

“…Other tumors include small cell carcinomas of the prostate and cervix, lymphomas, and adenocarcinomas. The prevalence of LEMS in patients with SCLC is estimated to be around 3% [87,89]. Clinically and serologically, the 30% without identifiable tumors are indistinguishable from the paraneoplastic LEMS patients, although LEMS may have a more progressive course in patients with SCLC [85].…”

A photoreceptor calcium binding protein is recognized by autoantibodies obtained from patients with cancer-associated retinopathy.

“…variety of neurodegenerative diseases are known to be associated with different types of cancer, even though the tumor and its metastases have not invaded the nervous system (Brain and Norris, 1965;Brain and Wilkinson, 1965;Brain et al, 1951;Croft and Wilkinson, 1963;Denny-Brown, 1948;Hawley et al, 1980;Henson and Urich, 1982;Minna and Bunn, 1982;Norris, 1972). These "remote effects" of cancer, or paraneoplastic syndromes, are of undetermined etiology, although some studies have implicated viral, hormonal or toxic origins (Brain and Norris, 1965;Hawley et al, 1980;Sawyer et al, 1976;Schold et al, 1979).…”

“…These "remote effects" of cancer, or paraneoplastic syndromes, are of undetermined etiology, although some studies have implicated viral, hormonal or toxic origins (Brain and Norris, 1965;Hawley et al, 1980;Sawyer et al, 1976;Schold et al, 1979). Alternatively, these degenerative diseases may stem from an autoimmune response that is directed towards antigens or epitopes found in both the tumor and specific neurons (Anderson et al, 1988;Keltner et al, 1983;Kornguth et al, 1982).…”

Acute Paraneoplastic Dysautonomia

“…We did not think that our patient had paraneoplastic cerebellar degeneration secondary to SCLC. Unlike patients with gynecological tumors, Erlington et al [5] (150 patients) and Hawley et al [6] (71 patients) reported no cerebellar syndrome at presentation in patients with SCLC.…”