- 期刊
Lambert-Eaton Myasthenic Syndrome Associated with Small Cell Lung Cancer-A Case Report
Lambert-Eaton氏肌無力症候群合併小細胞肺癌－病例報告
摘要
Lambert-Eaton氏肌無力症候群為一少見的神經肌肉疾病，其在病理生理上的特性為一自體免役機制，自體分泌的G型免役球蛋白(IgG)與節前神經末稍上的電位制動鈣離子通道(voltage-gated calcium channels, VGCCs)結合，其引發的一序列生化反應致使節前神經元末稍無法順利釋放乙醯膽鹼(Acetylcholine)，導致肌肉無力以及肌腱反射下降。約有60%的Lambert-Eaton氏肌無力症候群病人合併有小細胞肺癌。我們在此報告一位63歲男性病患在Lambert-Eaton氏肌無力症候群發生後約一年由胸部斷層掃瞄發現主氣管分枝(Carina)下腫塊，經支氣管鏡細針穿壁抽吸，細胞學檢查確診為小細胞肺癌，局限期。經以Cisplatin和etoposide(PVP)化學治療，一個月後肌無力已顯著改進，癌腫塊也明顯縮小。
並列摘要
Lambert-Eaton myasthenic syndrome (LEMS) is a rare neuromuscular disorder characterized by the defective release of neurotransmitters from pre-synaptic nerve terminals. It is an autoimmune condition associated with autoantibody immunoglobulin G (IgG) targeted at voltage-gated calcium channels (VGCCs). It is also associated with small cell lung cancer (SCLC) in about 60% of cases. We report a patient with SCLC initially presenting with LEMS. This 63-year-old-male first experienced progressive weakness of the 4 limbs within about a 1-year period; LEMS was diagnosed with electrophysiologic studies. Chest computed tomography (CT) then revealed a mass shadow at the subcarinal area. Cytology study of the bronchoscopic transbronchial fine needle aspiration revealed SCLC, limited in stage. The carcinoma responded to a chemotherapy regimen of cisplatin and etoposide. The weakness of the 4 limbs improved significantly within 1 month after the first cycle of chemotherapy. The subcarinal mass also regressed significantly with chemotherapy.
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