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

Year 2022, Volume: 14 Issue: 2, 424 - 428, 29.06.2022

Türkay Akbaş , Sinem Coşkun Kantarcıoğlu , Serkan Torun , Ayhan Öztürk , Onur Eşbah , Ömer Önbaş

https://doi.org/10.18521/ktd.1019045

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

Supporting Institution

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Thanks

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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.

Project Number

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References

• 1. Graus F, Delattre JY, Antoine JC, Dalmau J, Giometto B, Grisold W, et al. Recommended diagnostic criteria for paraneoplastic neurological syndromes J Neurol Neurosurg Psychiatry. 2004;75:1135-40.
• 2. Darnell RB, Posner JB. Paraneoplastic syndromes affecting the nervous systems. Semin Oncol. 2006;33:270-98.
• 3. Antoine JC, Camdessanché JP. Paraneplastic neuropathies. Curr Opin Neurol. 2017;30(5):513-20.
• 4. Kasajima A, Klöppel G. Neuroendocrine neoplasms of lung, pancreas and gut: a morphology-based comparison. Endocr Relat Cancer. 2020;27(11):R417-R432.
• 5. Sorbye H, Strosberg J, Baudin E, Klimstra DS, Yao JC. Gastroenteropancreatic high-grade neuroendocrine carcinoma. Cancer. 2014;120:2814-23.
• 6. Vijayaraghavan A, Alexander PT, Nair AV, Sivadasan A, Mani AM, Mathew D, et al. Clinical spectrum, therapeutic outcomes and prognostic predictors in paraneoplastic neurological syndromes-experience from a tertiary care center in India. Ann Indian Acad Neurol. 2021;24(1):32-9.
• 7. Candler PM, Hart PE, Barnett M, Weil R, Rees JH. A follow-up study of patients with paraneoplastic neurological disease in the United Kingdom. J Neurol Neurosurg Psychiatry. 2004;75:1411-5.
• 8. Giometto B, Grisold W, Vitaliani R, Graus F, Honnorat J, Bertolini G. Paraneoplastic neurological syndrome in the PNS Euronetwork database: a European study from 20 centers. Arch Neurol. 2010;67(3):330-5.
• 9. Antoine JC, Mosnier JF, Absi L, Convers P, Honnorat J, Michel D. Carcinoma associated paraneoplastic pheripheral neuropathies in patients with and without anti-onconeural antibodies. J Neurol Neurosurg Psychiatry. 1999;67:7-14.
• 10. Taskin OC, Clarke CN, Erkan M, Tsai S, Evans DB, Adsay V. Pancreatic neuroendocrine neoplasms: current state and ongoing controversies on terminology, classification and prognostication. J Gastrointest Oncol. 2020;11(3):548-58.
• 11. Lee L, Igarashi H, Fujimori N, Hijioka M, Kawabe K, Oda Y, et al. Long-term outcomes and prognostic factors in 78 Japanese patients with advanced pancreatic neuroendocrine neoplasms: a single-center retrospective study. Jpn J Clin Oncol. 2015;45(12):1131-8.
• 12. Sorbye H, Welin S, Langer SW, Vestermark LW, Holt N, Osterlund P, et al. Predictive and prognostic factors for treatment and survival in 305 patients with advanced gastrointestinal neuroendocrine carcinoma (WHO G3): The NORDIC NEC study. Ann Oncol. 2013;24:152-60.