Paraneoplastic Severe Sensorimotor Axonal Polyneuropathy in Pancreatic Neuroendocrine Carcinoma: A Case Report and Review Of The Literature

Abstract

Objective: Paraneoplastic neurological syndromes (PNSs) are a diverse group of neurological disorders affecting any part of the nervous system before or during cancer. Case: A 78-year-old patient had pain and burning sensation first in the upper extremity 3 years ago, and then, muscle weakness was added a short time later. The same symptoms developed in the lower extremities 1 year ago. He was admitted to the intensive care unit due to pneumonia and was conscious but quadriplegic with a modified Rankin score of 5. Abdominal computed tomography showed mass lesions in the liver and pancreas. The biopsies demonstrated pancreatic small cell neuroendocrine carcinoma. Electrophysiological studies disclosed severe sensorimotor axonal polyneuropathy. Since other polyneuropathy causes were excluded, the diagnosis was paraneoplastic sensorimotor axonal polyneuropathy. Palliative care was considered because the patient had a poor functional state. Conclusion: Early cancer diagnosis is paramount in patients with PNSs to have appropriate therapy.

Keywords

• Neuroendocrine carcinoma
• quadriplegia
• Ki67
• paraneoplastic neurological syndromes.

Pankreatik Nöroendokrin Karsinomda Paraneoplastik Ciddi Sensorimotor Aksonal Polinöropati: Vaka Sunumu ve Literatür Taraması

Abstract

Amaç: Paraneoplastik nörolojik sendromlar (PNSs), kanser öncesi veya kanser sırasında gelişen, sinir sisteminin herhangi bir kısmını etkileyen çeşitli nörolojik hastalıkları içermektedir. Vaka: Yetmiş sekiz yaşında erkek hastanın üç yıl önce üst ekstremitelerde ağrı ve yanma hissi şikayetleri başlamış ve kısa süre sonra kas güçsüzlüğü eklenmiş. Bir yıl önce de alt ekstremitelerde benzer şikayetler ortaya çıkmış. Yoğun bakım ünitesine pnömoni tansıyla yatırılan hastanın yatış esnasında bilinci açık, fakat kuadriplejik ve modifiye Rankin skoru 5 idi. Abdomen bilgisayarlı tomografi karaciğer ve pankreasta kitle lezyonlarının olduğunu gösterdi. Lezyonyonlardan alınan biyopsiler pankreas orjinli küçük hücreli nöroendokrin karsinom olarak raporlandı. Elektrofizyolojik testler ciddi sensorimotor aksonal polinöropati ile uyumluluk gösteriyordu Diğer polinöropati nedenleri dışlandıktan sonra, hastaya paraneoplastik sensorimotor aksonal polinöropati tanısı konuldu. Hastanın fonksiyonel kapasitesi düşük olduğundan sadece palyatif tedavi planlandı. Sonuç: PNS’li hastalarda uygun tedavinin başlanması için erken kanser tanısının konulması önem arz etmektedir.

Keywords

• Nöroendokrin Karsinom
• Kuadripleji
• Ki67
• Paraneoplastik nörolojik sendromlar

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