Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149925 (small cell lung cancer)
 6,491 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 58-year-old man was admitted to our hospital because of cough, polydipsia and polyuria. Chest CT films showed mediastinal lymphadenopathy, nodules in the lung fields, and pleural effusion. Histopathologic examination of transbronchial biopsy specimens showed oat cell carcinoma. MRI films revealed tumorous swelling of the pituitary stalk. Central diabetes insipidus caused by pituitary metastasis of small cell lung cancer was diagnosed. After treatment with whole-brain irradiation and chemotherapy, the size of the swollen pituitary stalk was reduced and his urine volume decreased. He died of respiratory insufficiency 15 months after the initial diagnosis. No recurrence of pituitary metastasis was apparent. This was a rare case of central diabetes insipidus caused by pituitary metastasis of small cell lung cancer successfully treated with radiotherapy and chemotherapy.
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PMID:[A case of central diabetes insipidus caused by metastatic small cell lung cancer]. 1197 72

Among patients with lung cancers, the proportion of those with small cell lung cancer (SCLC) has decreased over the last decade. SCLC is staged as limited-stage disease and extensive-stage disease. Standard staging procedures for SCLC include CT scans of the chest and abdomen, bone scan, and CT scan or MRI of the brain. The role for positron emission tomography scanning in the staging of SCLC has yet to be defined. Limited-stage disease is treated with curative intent with chemotherapy and radiation therapy, with approximately 20% of patients achieving a cure. The median survival time for patients with limited-stage disease is approximately 18 months. Extensive-stage disease is treated primarily with chemotherapy, with a high initial response rate of 60 to 70% and a complete response rate of 20 to 30%, but with a median survival time of approximately 9 months. Patients achieving a complete remission should be offered prophylactic cranial irradiation. Currently, there is no role for maintenance treatment or bone marrow transplantation in the treatment of patients with SCLC. Relapsed or refractory SCLC has a uniformly poor prognosis. In this section, evidence-based guidelines for the staging and treatment of SCLC are outlined.
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PMID:Small cell lung cancer. 1252 84

Chemotherapy and radiotherapy are the keys of current management of SCLC. For many years, the diagnosis of small cell lung cancer has been considered a contraindication to surgery because radiotherapy was at least equivalent in terms of local control and the rate of resectability of SCLC patients was poor. The role of surgery has been defined by evidence accumulated in the last 30 years but conclusions are limited by the fact that the most important studies are dated and conducted when the main staging tool was exploratory thoracotomy. The rationale for surgery in the context of SCLC is based on 3 factors: 1) Several historical series on patients operated for limited SCLC reported some long term survivors, showing that permanent cure can be achieved. For this reason, it is now accepted that for the rare patients with very limited stage disease (T1-T2 tumors) surgical resection followed by platinum-based chemotherapy could be offered. 2) After chemotherapy and radiotherapy, the rate of local relapse is 20-30%. The assumption that surgery might be superior to radiotherapy in local control of limited SCLC has been suggested but not still proved. 3) Surgery can precisely assess pathological response to chemotherapy, identify carcinoids erroneously diagnosed as SCLC, treat the NSCLC component of tumors with a mixed histology. In the case of planned surgery, preoperative investigations should be completed by MRI of the brain, mediastinoscopy (to rule out subclinical N2/N3 patients) and probably PET scan. Even if some controversies exist, it is accepted that surgery can be proposed as the first treatment in patents with T1-T2 lesions without sign of lymph nodes involvement, followed by adjuvant chemotherapy. Surgery in stage II and III must be planned on a multidisciplinary basis, in the context of controlled clinical trials.
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PMID:Surgery in small-cell lung carcinoma. Where is the rationale? 1450 50

The aim of this study was to assess the prognosis in LD SCLC pts according to their performance status, local extension of lesions, type of treatment and the completeness of staging. In the period 01.01.1986-31.12.1996 in the Institute of Tuberculosis and Chest Diseases 579 consecutive SCLC pts were treated. LD was diagnosed in 345 pts. In 193 out of them the staging was complete that is in addition to chest x-ray, abdomen USG/CT, brain CT/MRI and bilateral bone marrow trepanobiopsy was done. 152 pts were also regarded as limited but the staging was not complete. LD pts proved by complete staging survived significantly longer (median survival 15.7 months) than others (median survival 10.2 months). The pts in whom complete staging was done were however in better performance status and had smaller local extension of lesions and had more often radiotherapy than others. Status performance, local extension of lesions and radiotherapy but also completeness of staging were independent prognostic factors in multivariate analysis.
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PMID:[Prognosis in limited disease (LD) small cell lung cancer (SCLC) patients according to status performance, local extension of lesions, type of treatment and the completeness of staging]. 1458 19

Paraneoplastic neurological syndromes are frequently associated in patients with small cell lung cancer (SCLC) and antineuronal antibodies are involved in the autoimmune mechanism. Multiple syndromes are sometimes complicated in a single patient with SCLC. However, little is known about non-SCLC-associated neurological manifestations. We report two patients with complicated paraneoplastic neurological syndromes. Patient 1 showed paraneoplastic limbic encephalitis (PLE), paraneoplastic sensory neuropathy (PSN) and Lambert-Eaton myasthenic syndrome (LEMS) associated with SCLC. Patient 2 developed opsoclonus-ataxia and probable PLE associated with non-SCLC. Analysis of various antineuronal antibodies revealed that anti-Hu and P/Q-type voltage-gated calcium channel (VGCC) antibodies were positive in Patient 1 but any antibodies were not in Patient 2. Brain MRI demonstrated high intensity signals in temporal lobes particularly on fluid-attenuated inversion recovery (FLAIR) or diffusion-weighted images. These findings suggest that complicated paraneoplastic neurological syndromes occur in non-SCLC as well as SCLC and that unidentified antineuronal autoantibodies may underlie the pathophysiology.
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PMID:Complicated paraneoplastic neurological syndromes: a report of two patients with small cell or non-small cell lung cancer. 1464 18

In a case with small cell carcinoma of lung, typical features of Parinaud's syndrome were seen. MRI and EEG revealed no involvement of central nervous system. Tests for specific infections and connective tissue diseases did not indicate abnormal findings. No electrophysiological findings suggesting the involvement of the peripheral and neuromuscular systems were seen using EMG-NCV measurements and repetitive electrical stimulations. Although no immunological studies were carried out, Parinaud's syndrome in this case can be attributed to a remote effect of the lung cancer.
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PMID:A case of Parinaud's syndrome due to the remote effect of small cell carcinoma. 1475 56

CMT with surgery and chemotherapy is feasible, the toxicity is manageable, and postoperative morbidity and mortality rates are acceptable. Patient selection is important, and the results of the LCSG trial indicate that surgical resection will not benefit most patients who have limited SCLC. The chances of long-term survival and cure are strongly correlated with pathologic TNM stage. Consideration of surgery for patients who have SCLC should be limited to those with stage I disease and perhaps some patients with stage II tumors. Therefore, before surgery is undertaken, patients should undergo extensive radiologic staging with CT, MRI, and perhaps even positron emission tomographic scanning and mediastinoscopy, even if the radiologic assessment of the mediastinum is negative. Surgery may be considered for patients with T1-T2 NO SCLC tumors, and whether it is offered as the initial treatment or after induction chemotherapy remains controversial [40,43]. If SCLC is identified unexpectedly at the time of thoracotomy, complete resection and mediastinal lymph node resection should be undertaken, if possible. Chemotherapy is recommended postoperatively for all patients, even those with pathologic stage I tumors. Surgery likely has very little role to play for most patients with stage II disease and virtually no role for patients with stage III tumors. Even though chemotherapy can result in dramatic shrinkage of bulky mediastinal tumors, the addition of surgical resection does not contribute significantly to long-term survival for most patients, as shown conclusively by the LCSG trial. The final group of patients who may benefit from surgical resection are those with combined small cell and non-small cell tumors. If a mixed-histology cancer is identified at diagnosis, the initial treatment should be chemotherapy to control the small cell component of the disease, and surgery should be considered for the non-small cell component. For patients who demonstrate an unexpectedly poor response to chemotherapy, and for patients who experience localized late relapse after treatment for pure small cell tumors, a repeat biopsy should be performed. Surgery may be considered if residual NSCLC is confirmed.
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PMID:Should aggressive surgery ever be part of the management of small cell lung cancer? 1538 3

We encountered a very rare case of cT0N2M0 small cell lung cancer (SCLC) with Lambert-Eaton myasthenic syndrome (LEMS). A 69-year-old man with a complaint of muscle weakness was admitted to our hospital. Although his chest radiograph on admission showed no abnormal findings, CT scanning detected a mediastinal lymphadenopathy. Also, 2-[18F]-2-fluorodeoxy-D-glucose position emission tomography (FDG-PET) revealed increased accumulation in the same portion in the mediastinum. A diagnosis of LEMS was made from the distinctive electromyogram (EMG) findings (waning and waxing phenomenon in response to low-and high-frequency repetitive stimulation, respectively) in combination with the increased serum level of a P/Q-type anti-voltage-gated calcium channel (VGCC) antibody. Subsequent histopathological diagnosis by mediastinoscopic resection of a paraaortic lymph node was small cell carcinoma. No distant metastasis was detected by MRI of the brain, abdominal CT scan or an FDG-PET. Eight courses of chemotherapy (carboplatin + etoposide) with radiotherapy of the mediastinum (for a total dose of 45 Gy) was performed. A decreased serum level of P/Q-type anti-VGCC antibody titers followed by marked improvement of neurological dysfunction (muscle weakness, gait disturbance and scanning speech) and of an EMG finding (a loss of waning phenomenon) was observed. A close relationship between reduction of the antibody titers and improvement of neurological symptoms after the therapy was noticed. It was suggested that monitoring the level of a P/Q-type anti-VGCC antibody titer in the serum is important for evaluating the efficacy of chemotherapy for LEMS associated with SCLC.
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PMID:[A case of cT0N2M0 small cell lung cancer with Lambert-Eaton myasthenic syndrome]. 1550 Jan 50

Paraneoplastic limbic encephalitis is a rare clinical entity, most often associated with small cell lung cancer. We report a case of a 54-year-old man presenting status epilepticus, cognitive dysfunction and loss of short term memory associated with epidermoid lung carcinoma. CT scan was normal whereas MRI revealed hyperintensities on T2WI and FLAIR images in the temporolimbic regions. Treatment of the primary tumour was followed by neurological improvement.
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PMID:[Paraneoplastic limbic encephalitis associated with epidermoid lung carcinoma]. 1623 68

Cerebral metastases are a frequent complication of lung cancer. They often determine patients' prognosis and need urgent therapeutic intervention. Based on histologic type, former therapies, age and performance of the patient, the number of cerebral lesions and the extracerebral tumour activity, individualized treatments are applied. For patients who suffer from non-small cell lung cancer and a single CNS lesion the best results can be achieved if they are surgically resected or receive radiosurgery. Their survival time can be markedly increased in comparison to patients who undergo whole brain irradiation. If multiple metastases are seen in CT or MRI, whole brain irradiation is the therapy to choose. Furthermore it should be initiated if small cell lung cancer metastasizes to the brain. More aggressive local treatment options appear promising, but a clear role for them has not yet been defined. Systemic chemotherapy gains more attention in the treatment of small and non-small cell lung cancer with brain metastases. How to increase the efficacy through simultaneous application of chemo- and radiotherapy is tested in current trials. This article gives an overview on clinical presentation and diagnosis of cerebral metastases in lung cancer and reviews current treatment options.
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PMID:[Brain metastases of lung cancer]. 1642 40


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