KÜÇÜK HÜCRELİ AKCİĞER KANSERİ İLE LAMBERT-EATON MİYASTENİK SENDROMU BİRLİKTELİĞİ: OLGU SUNUMU

Öz

Lambert Eaton Miyastenik Sendrom (LEMS), presinaptik terminaldeki P/Q tip voltaja bağımlı kalsiyum kanallarına (VGCC) karşı oluşan otoantikorların sorumlu olduğu bir otoimmun kas sinir kavşağı hastalığıdır. Ender rastlanan bir hastalık olan LEMS daha çok 40 yaşın üzerinde başlar. Olguların % 50Õsinde küçük hücreli akciğer kanseri ile birliktelik saptanmıştır. 48 yaşında erkek hasta kliniğimize Lambert-Eaton Myastenik Sendrom tanısı ile başvurdu. Toraks BT'de sağ hiler bölgede yumuşak doku kitlesi mevcuttu. Konveks problu endobronşiyal ultrasonografi ile kitleden transbronşial iğne aspirasyonu yapıldı. Patoloji sonucu küçük hücreli akciğer karsinomu olarak raporlandı. Kemoterapi ve radyoterapi tedavileri başlanan hasta 1. yılında takibimiz altındadır. Olgu nadir görülmesi nedeni ile sunuldu.

Anahtar Kelimeler

• Lambert Eaton Myastenik Sendrom, Küçük Hücreli Akciğer Karsinomu

SMALL CELL LUNG CANCER WITH LAMBERT-EATON MYASTENIC SYNDROME: A CASE REPORT

Öz

Lambert Eaton Myastenic Syndrome (LEMS), is an autoimmune neuromuscular junction disease which is responsible from autoantibodies against the presynaptic terminal P / Q type of voltage dependent calcium channel (VGCC). LEMS is a rare disease and starts more over 40 years of age. 50% of patients with small cell lung cancer were found together. 48 years old male patient applied to our clinic with a diagnosis of of Lambert-Eaton myasthenic syndrome.Right hilar soft tissue mass was presented on thorax CT. Transbronşial needle aspiration was performed from mass with endobronchial ultrasonography with convex probe. Pathology result was reported as small cell lung carcinoma. Patient that has chemotherapy and radiotherapy treatments is in our follow-up at his first year. Was presented because of rare case.

Anahtar Kelimeler

• Lambert Eaton Myastenic Syndrome, Small Cell Lung Carcinoma

Kaynakça

1. 1. Block JB. Paraneoplastic syndrommes, in Haksel CM (ed), Cancer Treatment, 4th ed. Philadelphia, WB Saunders, 1995, pp 245-6.
2. 2. Romics L Jr, McNamara B, Cronin PA, O'Brien ME, Relihan N, Redmond HP.. Unusual paraneoplastic syndromes of breast carcinoma: a combination of cerebellar degeneration and Lambert-Eaton Myasthenic Syndrome. Ir J Med Sci 2008; 13.
3. 3. Çetinkaya E., Alt›n S., Küçükler K. ve ark. Küçük Hücreli Akci¤er Karsinomlu Olguda Eaton-Lambert Myastenik Sendrom. Türkiye Hastane T›p Dergisi 2003; 57: 1.
4. 4. Dalman JO,Posner JB. Paraneoplastic syndromes affecting the nervous system. Semin Oncol 1997; 24: 318.
5. 5. Mareska M, Gutmann L. Lambert-Eaton myastehenic syndrome. Semin Neurol 2004; 24: 149-53.
6. 6. Victor M,Allan HR.Myastenia gravis and related disorders of the neuromuscular junction.In:Adams and Victor’s Principles of Neurology. 7.ed. New York, Mc Graw Hill Co., 2001: 1536-52
7. 7. Kleopa KA, Teener JW, Scherer SS, Galetta SL, Bird SJ. Chronic multiple paraneoplastic syndromes. Muscle Nevre 2000; 23: 1787-92.
8. 8. Parsons KT, Kwok WW, Gaur LK, Nepom GT. Increased freque ncy of HLA class II alleles DRB1*0301 and DQB1*0201 in LambertEaton myasthenic syndrome without associated cancer. Hum Immunol 2000; 54: 2176-8.

9. 9. Seneviratne U, de Silva R. Lambert-Eaton myastehenic syndrome. Postgrad Med J 1999; 75: 516-20.
10. 10. Demirer T, Ravits J, Abolulafia D. Myasthenic (Lambert-Eaton) syndrome associated with pulmonary large-cell neuroendocrine carcinoma. South Med J 1994; 87: 1186-9.
11. 11. Lin JT, Lachmann E. Lambert-eaton myasthenic syndrome: a case report and review of the literature. J Womens Health (Larchmt) 2002; 11: 849-55.
12. 12. Sanders DB. Lambert-eaton myasthenic syndrome: diagnosis and treatment. Ann NY Acad Sci 2003; 998: 500-8.
13. 13. Maddison P, Newsom-Davis J. Treatment for Lambert-Eaton myasthenic syndrome Cochrane Database Syst Rev 2005; 18: 2: (CD0032794).