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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)

Intramedullary spinal cord metastases (ISCM) are usually the result of rapidly progressing systemic malignancy. Lung cancer represents the most common solid tumor associated with the development of ISCM. We describe a 47-year-old female with atypical small cell lung cancer (SCLC) developing ISCM. After a thoracoscopic biopsy she was treated with combination chemotherapy consolidated by mediastinal radiotherapy leading to complete remission. Three months later, she developed a Brown-Sequard syndrome and an MRI scan revealed ISCM at the T10-T12 levels, and secondary brain lesions. Despite treatment with steroids and thoracic spine/brain radiotherapy, no recovery of her motor function was seen and she died 4 months later due to progressive disease in the CNS. The present case, adds to the existing list of ISCM cases reported so far for lung cancer, undermine the ominous prognosis and limited treatment options available, and an extensive literature overview and discussion of similar cases is provided.
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PMID:Intramedullary spinal cord metastases from atypical small cell lung cancer: a case report and literature review. 1646 92

Approximately 20-25% of patients with limited small cell lung cancer (SCLC) can be cured with an aggressive approach (chest radiation concomitant with chemotherapy) followed by prophylactic cranial irradiation (PCI) to a total dose of 30-36Gy with 3-2Gy per fraction, five fractions per week. Steroid prophylactic therapy with dexamethasone is usually prescribed during PCI to minimize acute radiation induced brain oedema. This approach may induce an immunosuppressive condition leading to a reactivation of an endogenous latent Herpes simplex virus and severe or fatal acute encephalitis may occur as our report will show. A 55-year-old man affected by locally advanced SCLC was referred to our institution after four cycles of chemotherapy with a good partial remission. Chest radiation started concomitantly with two cycles of chemotherapy followed by PCI 36Gy total dose and dexamethasone 8mg i.m. daily. Fifteen days after PCI completion the patient developed acute neurological symptoms of confusion, cognitive impairment, fever with shaking requiring severe sedation therapy. Twenty-five days later MRI T1 weighted images showed haemorrhagic streaked lines on cortical convolutions of the right cerebral hemisphere and diffuse oedema suggestive of herpetic encephalitis. The DNA consensus test on cerebrospinal fluid (CSF) was positive for Herpes simplex virus 1 infection (HSV-1). A diagnosis of herpetic encephalitis HSV-1 was made. Antiviral therapy with high doses of acyclovir was prescribed but symptoms did not ameliorate leading to a comatose state. The patient died 55 days after the end of PCI. In eligible SCLC patients, PCI is an important part of an aggressive therapeutic approach that improves overall and disease free survival decreasing the risk of relapse in the brain. A primary infection or a reactivation of an endogenous latent HSV in brain parenchyma under steroid therapy concomitant to brain irradiation may compromise these benefits.
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PMID:A Herpes simplex virus-1 fatal encephalitis following chemo-radiotherapy, steroids and prophylactic cranial irradiation in a small cell lung cancer patient. 1736 25

In order to find out prognostic factors and treatment results in small cell lung cancer (SCLC), 40 patients diagnosed in one year period were prospectively analysed. Following history and physical examination, patients were grouped according to ECOG performance scale and underwent Chest X-ray and thoracic computerized tomography (CT). Complete blood count, biochemical analyses, tumor markers were taken. Abdominal USG or CT, bone scintigraphy, cranial CT or MRI and bone marrow biopsy were made for detection of metastases. Limited stage patients received chemotherapy and thoracic RT, whereas cases with extensive disease received chemotherapy. Nineteen cases had limited and 21 had extensive disease. When laboratory findings between 2 stages were compared, LDH, SGOT and GGT were significantly higher in extensive stage (p= 0.005, 0.015, 0.001, respectively). Overall median survival was 6 +/- 1 months, cumulative survival in 6 and 12 months were 39% and 20.72%, respectively. Median survival was 10 +/- 2 months in limited stage and 3 +/- 1 months in extensive stage, with a statististically significant difference. Univariate analyses showed that incresed LDH, CA15-3, GGT and SGOT levels, hipoproteinemia and poor performance scale were poor prognostic signs (p= 0.024, 0.032, 0.047, 0.013, 0.021 ve 0.013, respectively), however multivariate analyses revealed no significant difference. Other blood tests, pleural effusion, age, mediastinal lymph node metastases and weight loss had no prognostic effect. Stage was found to be progniostic factor with both univariate and multivariate analyses (p= 0.045).
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PMID:[Prognostic factors in small cell lung cancer]. 1833 Jul 51

When a 45-year-old man visited his local hospital with a complaint of chest discomfort and coughing, an abnormal chest X-ray shadow was found. On referral to our department, pigmentation was mainly observed on his face, however, no striae cutis distensae or facial swelling was observed. After a systemic examination, Stage IV small cell lung cancer with Cushing's syndrome was diagnosed. Marked increases in ACTH levels were observed, but no abnormality was found in the pituitary MRI findings, and therefore ACTH-producing small cell lung cancer was suspected. Chemotherapy was administered in addition to appropriate treatment for Cushing's syndrome. The tumor temporarily began to decrease in size, but hypercortisolemia remained, and thus adrenal hormone synthesis-inhibiting therapy was concurrently administered. Subsequently, cortisole began to decrease, but it could not be sufficiently controlled, resulting in occasional colonization by bacteria. Hypercortisolemia is believed to induce the suppression of the immune system, thereby affecting the outcome and QOL more than the immediate symptoms of cancer. Therefore, from an early stage, it is believed that adrenal cortical hormone synthesis-inhibiting therapy should be performed concurrently with chemotherapy, if hypercortisolemia cannot be controlled by radiation and chemotherapy alone.
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PMID:[A case of small cell lung cancer complicated by Cushing syndrome]. 1840 68

A 65-year-old man was admitted to our hospital complaining of diplopia, dysarthria, difficulty in walking and progressive dysesthesia that developed in his left hand and leg. Brain MRI revealed high signal intensity regions on T2-weighted and FLAIR images of the hippocampus and the corpus amygdaloideum. After admission, the patient's neurological symptoms progressed to delirium and dementia with hallucinations. When he eventually developed severe respiratory failure requiring ventilatory support, brain MRI revealed new high signal intensity regions on T2-weighted images of the medulla oblongata and pons. Chest CT scans showed a mass under the aortic arch, and based on subsequent histopathological examination of a transesophageal endoscopic ultrasonography-guided fine needle aspiration biopsy of the tumor, a diagnosis of small cell lung cancer was made. In addition, anti-Hu antibody was found in the patient's serum, leading to a diagnosis of paraneoplastic encephalomyelitis/sensory neuropathy. One course of chemotherapy (carboplatin + etoposide) was administered; however, the protocol was not completed because the patient developed severe pneumonia. Given that neurological symptoms usually precede a diagnosis of malignancy in paraneoplastic neurological syndromes, it is important that these are considered carefully, as they may contribute to early diagnosis and treatment. Here we report a rare case of severe central hypoventilation in paraneoplastic encephalomyelitis/sensory neuropathy.
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PMID:[Paraneoplastic neurological syndrome accompanied by severe central hypoventilation and expression of anti-Hu antibody in a patient with small cell lung cancer]. 1851 96

We describe a man who was diagnosed with non-small cell lung cancer following previous treatment for small cell lung cancer. He developed dyspnoea, paroxysmal nocturnal dyspnoea and orthopnoea. Trans-thoracic echocardiogram revealed a large mass within the right atrium. The patient proceeded to thoracotomy at which time unresectable metastatic tumour was found in the right atrium infiltrating into the pericardium. Metastatic involvement of the heart by tumour is rare and is found at autopsy in 1-3% of unselected cases in various series. This translates into a finding of cardiac metastases in approximately 10% of autopsies where malignancy is diagnosed. Most cases are clinically silent and are undiagnosed in vivo. Echocardiography, CT and MRI are complementary investigations, and are all used in the evaluation of cardiac lesions. When metastatic disease is in question, MR and CT imaging offer advantages over echocardiography, chiefly a wider imaging field which allows evaluation of distant disease.
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PMID:Symptomatic intra-cardiac metastasis complicating non-small cell lung cancer: imaging findings and clinical course. 1895 20

Paraneoplastic chorea occurs most commonly in association with small cell lung cancer, often in combination with other paraneoplastic phenomena and sometimes with distinctive basal ganglia T2-weighted MRI hyperintensities. A case of acute-onset chorea is presented in which this phenomenon, combined with transverse myelitis, neuropathy and the described characteristic MRI changes prompted positron emission tomography scanning, in which evidence of probable small cell cancer was uncovered.
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PMID:Chorea, transverse myelitis, neuropathy and a distinctive MRI: paraneoplastic manifestations of probable small cell lung cancer. 1932 21

A 60-year-old man presented with vitritis and optic neuropathy in the setting of headaches and behavioral changes. MRI brain revealed bilateral temporal lobe inflammation consistent with limbic encephalitis. He was subsequently diagnosed with small cell lung cancer with a paraneoplastic syndrome characterized by CRMP5 IgG as a cause of his symptoms. His visual symptoms improved markedly after anti-inflammatory therapy and his cognitive symptoms were mildly better following systemic chemotherapy. The clinical presentation, pathophysiology, and therapy of CRMP5 associated paraneoplastic syndromes are discussed.
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PMID:Glazed (vision) and confused. 1980 92

The prognosis of lung cancer patients mostly depends on the stage at which the disease is diagnosed. Contrast-enhanced CT (ceCT) and MRI play a significant role in initial staging, but often the morphological information is insufficient when compared to the metabolic or molecular information obtained by positron emission tomography (PET). [18]F-fluorine deoxyglucose (FDG) is based upon the increased demand of ATP leading to increased consumption of glucose in the tumor tissues. FDG-PET/CT has been proven to be of immense value in the initial diagnosis, evaluation of therapy reponse, detection of recurrent tumor, radiation therapy planning and in the multidisciplinary management of patients with non-small cell lung cancer as well as in patients with small cell lung cancer. The aim of this article is to present a concise summary of the present status of FDG-PET/CT.
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PMID:FDG-PET/CT in lung cancer: an update. 1995 89

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.
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PMID:[A case of small cell lung carcinoma without apparent primary lesion accompanying Lambert-Eaton myasthenic syndrome]. 2005 96


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