Concomitant Acute Motor Sensory Axonal Neuropathy and Squamous Lung Cancer-Induced Intramedullary Spinal Cord Metastasis
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Abstract
Intramedullary Spinal Cord Metastases (ISCMs) are rare, especially in squamous non-small cell lung cancer simultaneous with Acute Motor and Sensory Axonal Neuropathy (AMSAN); diagnosing these phenomena may be challenging. We report a 56-year-old man presenting with rapidly symmetrical progressive ascending weakness and paresthesia, especially in lower extremities, urinary and fecal incontinence, without any pain or respiratory symptoms. Thoracic spine MRI with and without gadolinium revealed an enhancing intramedullary lesion at the T3-T5 level. Chest CT discovered subpleural pulmonary lesion. The result lung biopsy was consistent with poorly differentiated squamous cell carcinoma, and electrodiagnosis noted severe axonal loss in motor and sensory studies with significant membrane instability and neurogenic findings in electromyography. After 8 months, the patient received just one cycle of chemotherapy and died 6 months later. AMSAN was associated with ISCM of non- small cell lung cancer in this case, who has not been previously reported in the literature.
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[17] Kim MH, Hwang MS, Park YK, Park Y, Ahn YC, Oh HS, et al. Paraneoplastc Guillain-Barré syndrome in small cell lung cancer. Case Reports in Oncology. 2015; 8(2):295-300. [DOI:10.1159/000437295] [PMID] [PMCID]
[18] Minomo S, Tokoro A, Utsumi T, Ishihara M, Akira M, Atagi S. A case of long-term survival afer multmodal local treatments of intramedullary spinal cord metastasis of squamous cell lung cancer. Journal of Thoracic Disease. 2016; 8(8):E681-3. [DOI:10.21037/ jtd.2016.06.58] [PMID] [PMCID]
[19] Pot A, Abdel-Raheem M, Levit R, Schell DA, Mehdi SA. Intramedullary Spinal Cord Metastases (ISCM) and Non-Small Cell Lung Carcinoma (NSCLC): Clinical paterns, diagnosis and therapeutc consideratons. Lung Cancer. 2001; 31(2-3):319-23. [DOI:10.1016/ S0169-5002(00)00177-X]
[20] Payer S, Mende KC, Westphal M, Eicker SO. Intramedullary spinal cord metastases: An increasingly common diagnosis. Neurosurgical Focus. 2015; 39(2):E15. [DOI:10.3171/2015.5.FOCUS15149] [PMID]
[21] Khoshnevisan A, Abdollahzade S, Jahanzad I, Niknezhad A, Naderi S, Khadivi M. Intramedullary spinal cord metastasis from endometrioid adenocarcinoma. Archives of Iranian Medicine. 2014; 17(4):293-6.
[22] Wilson DA, Fusco DJ, Uschold TD, Spetzler RF, Chang SW. Survival and functonal outcome afer surgical resecton of intramedullary spinal cord metastases. World Neurosurgery. 2012; 77(2):370-4. [DOI:10.1016/j.wneu.2011.07.016] [PMID]
[2] Dam-Hieu P, Seizeur R, Mineo J, Metges JP, Meriot P, Simon H. Retrospectve study of 19 patents with intramedullary spinal cord metastasis. Clinical neurology and neurosurgery. 2009; 111(1):10-7.
[DOI:10.1016/j.clineuro.2008.06.019] [PMID]
[3] Parker AL, Pugh T, Hirsch MA. A rare intramedullary spinal cord metastasis from a retroperitoneal leiomyosarcoma presentng as a non-traumatc spinal cord injury. American Journal of Physical Medicine & Rehabilitaton. 2017; 96(7):e134-7. [DOI:10.1097/ PHM.0000000000000651] [PMID]
[4] Rostásy KM, Huppke P, Beckers B, Brockmann K, Degenhardt V, Wesche B, et al. Acute Motor And Sensory Axonal Neuropathy (AMSAN) in a 15-year-old boy presentng with severe pain and distal muscle weakness. Neuropediatrics. 2005; 36(4):260-4. [DOI:10.1055/s-2005-865774] [PMID]
[5] Chowdhury D, Arora A. Axonal Guillain-Barré Syndrome: A critcal review. Acta Neurologica Scandinavica. 2001; 103(5):267-77. [DOI:10.1034/j.1600-0404.2001.103005267.x] [PMID]
[6] Vigliani MC, Magistrello M, Polo P, Mutani R, Chiò A, Piemonte and Valle d’Aosta Register for Guillain-Barré Syndrome. Risk of cancer in patents with Guillain-Barré Syndrome (GBS): A populaton-based study. Journal of Neurology. 2004; 251(3):3229-34. [DOI:10.1007/ s00415-004-0317-3] [PMID]
[7] Kaushik R, Kharbanda PS, Bhalla A, Rajan R, Prabhakar S. Acute Flaccid paralysis in adults: Our experience. Journal of Emergencies, Trauma, and Shock. 2014; 7(3):149-54. [DOI:10.4103/0974- 2700.136847] [PMID] [PMCID]
[8] Soltani J, Esmailnasab N, Roshani D, Karimi M, Amjadi MJ. Acute flaccid paralysis and its differental diagnosis in Kurdistan Province, Western Iran: An 11-year surveillance. Iranian Journal of Pediatrics. 2014; 24(2):131–9. [PMID] [PMCID]
[9] Marx A, Glass JD, Suter RW. Differental diagnosis of acute flaccid paralysis and its role in poliomyelits surveillance. Epidemiologic reviews. 2000; 22(2):298-316. [DOI:10.1093/oxfordjournals.epirev. a018041] [PMID]
[10] Vucic S, Kiernan MC, Cornblath DR. Guillain-Barré syndrome: An update. Journal of Clinical Neuroscience. 2009; 16(6):733-41. [DOI:10.1016/j.jocn.2008.08.033] [PMID]
[11] Dimachkie MM, Barohn RJ. Guillain-Barré syndrome and variants. Neurologic Clinics. 2013; 31(2):491-510. [DOI:10.1016/j. ncl.2013.01.005] [PMID] [PMCID]
[12] Huynh W, Kiernan MC. Nerve conducton studies. Australian Family Physician. 2011; 40(9):693-7.
[13] Benecke R, Berthold A, Conrad B. Denervaton actvity in the EMG of patents with upper motor neuron lesions: Time course, local distributon and pathogenetc aspects. Journal of Neurology. 1983; 230(3):143-51. [DOI:10.1007/BF00313625]
[14] Chung H, Joa KL, Kim HS, Kim CH, Jung HY, Kim MO, et al. Concomitant acute transverse myelits and sensory motor axonal polyneuropathy in two children: Two case reports. Annals of Rehabilitaton Medicine. 2015; 39(1):142-5. [DOI:10.5535/arm.2015.39.1.142] [PMID] [PMCID]
[15] Colantuoni M, Matano E, Alferi S, De Placido S, Carlomagno C. Guillain-Barre syndrome associated with gastric cancer: Paraneoplastc syndrome or immunological disorder. World Journal of Oncology. 2010; 1(6):247-9. [DOI:10.4021/wjon259w] [PMID] [PMCID]
[16] Kiyat Atamer A, Okutur K, Tüzün E, Hasbal B, Boyaciyan A, Krespi Y, et al. Guillain-Barre syndrome in a patent with primary extranodal intestnal non-hodgkin’s lymphoma: Paraneoplastc, drug induced or coincidental. Nöro Psikiyatri Arşivi. 2014; 51(3):288-92. [DOI:10.4274/npa.y7059] [PMID] [PMCID]
[17] Kim MH, Hwang MS, Park YK, Park Y, Ahn YC, Oh HS, et al. Paraneoplastc Guillain-Barré syndrome in small cell lung cancer. Case Reports in Oncology. 2015; 8(2):295-300. [DOI:10.1159/000437295] [PMID] [PMCID]
[18] Minomo S, Tokoro A, Utsumi T, Ishihara M, Akira M, Atagi S. A case of long-term survival afer multmodal local treatments of intramedullary spinal cord metastasis of squamous cell lung cancer. Journal of Thoracic Disease. 2016; 8(8):E681-3. [DOI:10.21037/ jtd.2016.06.58] [PMID] [PMCID]
[19] Pot A, Abdel-Raheem M, Levit R, Schell DA, Mehdi SA. Intramedullary Spinal Cord Metastases (ISCM) and Non-Small Cell Lung Carcinoma (NSCLC): Clinical paterns, diagnosis and therapeutc consideratons. Lung Cancer. 2001; 31(2-3):319-23. [DOI:10.1016/ S0169-5002(00)00177-X]
[20] Payer S, Mende KC, Westphal M, Eicker SO. Intramedullary spinal cord metastases: An increasingly common diagnosis. Neurosurgical Focus. 2015; 39(2):E15. [DOI:10.3171/2015.5.FOCUS15149] [PMID]
[21] Khoshnevisan A, Abdollahzade S, Jahanzad I, Niknezhad A, Naderi S, Khadivi M. Intramedullary spinal cord metastasis from endometrioid adenocarcinoma. Archives of Iranian Medicine. 2014; 17(4):293-6.
[22] Wilson DA, Fusco DJ, Uschold TD, Spetzler RF, Chang SW. Survival and functonal outcome afer surgical resecton of intramedullary spinal cord metastases. World Neurosurgery. 2012; 77(2):370-4. [DOI:10.1016/j.wneu.2011.07.016] [PMID]
| Files | ||
| Issue | Vol 4 No 2 (2019): Spring | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v4i2.1702 | |
| Keywords | ||
| Acute motor sensory axonal polyneuropathy Lung cancer Spinal cord metastasis Acute flaccid paralysis Paraneoplastic syndromes | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Fateh H, Khoshnevisan A, Meshkini M, Heidari A. Concomitant Acute Motor Sensory Axonal Neuropathy and Squamous Lung Cancer-Induced Intramedullary Spinal Cord Metastasis. CRCP. 2019;4(2):29-34.
