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Query: UMLS:C0033377 (
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11,717
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A 56-year-old man had been complaining of progressive proximal muscle weakness and bilateral
ptosis
before his first admission to our hospital. He received an injection of edrophonium chloride, which resulted in remarkable improvement of muscle strength. Electromyographic studies revealed a compound muscle action potential that decreased after repetitive stimulation at a high rate (15 Hz). He was regarded as having myasthenia gravis (MG) rather than Eaton-Lambert syndrome because of these findings. Eighteen months after successful treatment of MG with oral anticholinesterase medication, he complained of an abdominal mass. The mass was found to be a tumor that had metastasized from a primary small cell
carcinoma of the lung
. Cases of MG with small cell
carcinoma of the lung
seem to be very rare, and the details of the relationship between them remain unknown. In this patient, MG may have developed by paraneoplastic mechanisms. This hypothesis is interesting, since it has been demonstrated recently by molecular biological techniques that small cell carcinomas of the lung express nicotinic acetylcholine receptors.
...
PMID:[A case of small cell lung cancer that developed during therapy for myasthenia gravis]. 779 Dec 77
Ocular manifestations of myasthenia gravis are very common. Myasthenia gravis may be associated with
lung carcinoma
. Lambert-Eaton syndrome is also commonly associated with
lung carcinoma
and can have ocular manifestations. Overlap of these two entities has been described. The case of a patient with fatigable diplopia and
ptosis
3 years after removal of a large-cell
lung carcinoma
is presented. Tests results for acetylcholine receptor binding and modulating antibodies were positive for myasthenia gravis. Test results for presynaptic voltage-gated calcium channel antibodies of the N-type were also positive. However, test results for the P/Q-type voltage-gated calcium channel antibodies, which are consistent with Lambert-Eaton syndrome, were negative. Autoantibodies can be used to serologically distinguish paraneoplastic myasthenia gravis from Lambert-Eaton syndrome.
...
PMID:Myasthenia gravis with a paraneoplastic marker. 1087 Sep 23
We describe a patient who presented with excessive daytime sleepiness (EDS) and was eventually diagnosed with anti-Ma2 encephalitis. Neurological examination disclosed somnolence, left palpebral
ptosis
, and vertical gaze paresis. A brain MRI showed high signal intensity in the hypothalamus and each hippocampus. Ma2 antibodies were found in the patient's serum, and fiberbronchoscopy disclosed a
lung carcinoma
. After three months of steroid treatment, the results of the patient's neurological exam became normal. We conclude that anti-Ma2 encephalitis may present with mostly isolated EDS and that it may respond to steroids despite old age and the presence of an untreated lung cancer.
...
PMID:Hypersomnia as presenting symptom of anti-Ma2-associated encephalitis: case study. 1701 96
A 58-year-old man complaining of increasing weakness of muscular leg strength, diplopia and
ptosis
was admitted to our hospital. An electromyogram (EMG) showed typical waxing phenomenon in response to high-frequency repetitive stimulation. A diagnosis of Lambert-Eaton myasthenic syndrome (LEMS) was made from his symptoms and EMG results. A chest CT showed mediastinal lymph node swelling. No abnormal mass was seen in either lung field. His serum levels of a P/Q-type anti-voltage-gated calcium channel (VGCC) antibody, Pro-GRP, and NSE were high. FDG-PET showed accumulation of FDG to the mediastinal and left inguinal lymph nodes. The left inguinal lymphadenopathy was pathologically diagnosed as metastasis of small cell
lung carcinoma
. No tumor could be detected by bronchofiberscopy. No other distant metastasis was detected by brain MRI, abdominal CT, or FDG-PET. After 6 courses of chemotherapy for SCLC, a partial response and reduction of symptoms were obtained. For assessment of indistinguishable neuropathic symptoms, the possible diagnosis of paraneoplastic syndrome, such as LEMS, and the fact that early treatment for primary disease was effective, should be considered.
...
PMID:[A case of small cell lung carcinoma without apparent primary lesion accompanying Lambert-Eaton myasthenic syndrome]. 2005 96
Superior sulcus tumors (SSTs), or as otherwise known Pancoast tumors, make up a clinically unique and challenging subset of non-small cell
carcinoma of the lung
(NSCLC). Although the outcome of patients with this disease has traditionally been poor, recent developments have contributed to a significant improvement in prognosis of SST patients. The combination of severe and unrelenting shoulder and arm pain along the distribution of the eighth cervical and first and second thoracic nerve trunks, Horner's syndrome (
ptosis
, miosis, and anhidrosis) and atrophy of the intrinsic hand muscles comprises a clinical entity named as "Pancoast-Tobias syndrome". Apart NSCLC, other lesions may, although less frequently, result in Pancoast syndrome. In the current review we will present the main characteristics of the disease and focus on the preoperative assessment.
...
PMID:Pancoast tumors: characteristics and preoperative assessment. 2467 86