PMID- 37335736
OWN - NLM
STAT- MEDLINE
DCOM- 20230621
LR  - 20230621
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 102
IP  - 20
DP  - 2023 May 19
TI  - Myasthenia-like paraneoplastic syndrome with multiple cranial nerve tumor 
      infiltration: A case report and literature review.
PG  - e33774
LID - 10.1097/MD.0000000000033774 [doi]
LID - e33774
AB  - RATIONALE: Approximately 0.001% of patients with cancer have paraneoplastic nerve 
      system syndrome, which can affect the central nervous system, neuromuscular 
      junction, or peripheral nervous system. Although myasthenia gravis (MG) may exist 
      as a thymic paraneoplastic syndrome (PNPS), its association with primary lung 
      cancer remains unknown. PATIENT CONCERNS: A 55-year-old female presented with 
      slurred speech, weakness in chewing, sporadic difficulty in swallowing, and 
      weakness in both lower limbs for half a year. DIAGNOSES: Based on cerebrospinal 
      fluid and electromyography findings, we present the case of a female patient 
      diagnosed with overlapping multicranial nerve tumor infiltration and MG-like 
      neurological PNPS secondary to lung adenocarcinoma. INTERVENTIONS: The patient 
      received intrathecal injections of pemetrexed and neurotrophic (vitamin B) 
      therapy before ceasing chemoradiotherapy and chose cabozantinib on her own. 
      OUTCOMES: Weakness of the proximal limbs, choking cough, and chewing problems did 
      not improve significantly. LESSONS: Although it is unclear why MG coexists with 
      lung cancer, it is probable that MG is a paraneoplastic condition. Cerebrospinal 
      fluid testing should be carried out along with electrophysiological, serological, 
      and pharmacological procedures pertinent to the diagnosis of MG to thoroughly 
      examine if people simultaneously experience MG-like PNPS and tumor growth. 
      Starting immunotherapy and anticancer medication at the same time that tumor 
      development and MG-like syndrome are discovered is crucial.
CI  - Copyright (c) 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Wen, Chunbei
AU  - Wen C
AUID- ORCID: 0000-0003-4892-6868
AD  - Department of Neurology, The First Hospital of Wuhan, Wuhan, P. R. China.
AD  - The First Clinical Medical Institute, Hubei University of Traditional Chinese 
      Medicine, Wuhan, P. R. China.
FAU - Yang, Jie
AU  - Yang J
AD  - Department of Neurology, The First Hospital of Wuhan, Wuhan, P. R. China.
FAU - Xu, Changyou
AU  - Xu C
AD  - Department of Neurology, The First Hospital of Wuhan, Wuhan, P. R. China.
AD  - The First Clinical Medical Institute, Hubei University of Traditional Chinese 
      Medicine, Wuhan, P. R. China.
FAU - Wei, Dongsheng
AU  - Wei D
AD  - Department of Neurology, The First Hospital of Wuhan, Wuhan, P. R. China.
FAU - Luo, Lijun
AU  - Luo L
AUID- ORCID: 0000-0002-0911-0279
AD  - Department of Neurology, The First Hospital of Wuhan, Wuhan, P. R. China.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Humans
MH  - Female
MH  - Middle Aged
MH  - *Myasthenia Gravis/complications
MH  - *Paraneoplastic Syndromes/etiology/complications
MH  - *Lung Neoplasms/complications/pathology
MH  - *Adenocarcinoma of Lung/complications
MH  - *Cranial Nerve Neoplasms
PMC - PMC10194617
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2023/06/19 19:11
MHDA- 2023/06/21 06:42
PMCR- 2023/05/17
CRDT- 2023/06/19 12:03
PHST- 2023/06/21 06:42 [medline]
PHST- 2023/06/19 19:11 [pubmed]
PHST- 2023/06/19 12:03 [entrez]
PHST- 2023/05/17 00:00 [pmc-release]
AID - 00005792-202305190-00052 [pii]
AID - 10.1097/MD.0000000000033774 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2023 May 19;102(20):e33774. doi: 
      10.1097/MD.0000000000033774.