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Gastric cancer complicated by paraneoplastic neurological syndrome which presented with extremity numbness : a case report

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Title: Gastric cancer complicated by paraneoplastic neurological syndrome which presented with extremity numbness : a case report
Authors: Yoshida, Takuto Browse this author
Kawamura, Hideki Browse this author →KAKEN DB
Mino, Kazuhiro Browse this author
Konishi, Yuji Browse this author
Saito, Tomoya Browse this author
Shimizu, Yuichi Browse this author →KAKEN DB
Taketomi, Akinobu Browse this author →KAKEN DB
Keywords: Gastric cancer
Paraneoplastic neurological syndrome
Neurological disorder
Issue Date: 28-Apr-2022
Publisher: Springer
Journal Title: Surgical case reports
Volume: 8
Issue: 1
Start Page: 78
Publisher DOI: 10.1186/s40792-022-01429-2
Abstract: Background Paraneoplastic neurological syndromes refer to a group of neurological disorders, which occur as distant effects of malignant tumors and are not caused by metastasis, nutritional disorders, or side effects of antitumor drugs. Case presentation A 70-year-old woman complained of a 1-month history of extremity numbness. Upon presentation to our hospital, she had worsening numbness, and experienced staggering and falling. Physical examination revealed diminished tendon reflexes in both lower limbs, stocking and glove-type abnormal sensation, and left-sided dominant high-steppage gait due to weakness of the bilateral tibialis anterior muscles. Blood tests indicated anemia, and upper gastrointestinal endoscopy revealed gastric cancer, leading to laparoscopic distal gastrectomy. A nerve conduction velocity test showed demyelinating peripheral neuropathy. Further blood tests and imaging studies ruled out nutritional disorders, such as vitamin deficiency, diabetes-related diseases, connective tissue diseases, and central nervous system metastasis, leading to the suspicion of paraneoplastic neurological syndrome. After laparoscopic distal gastrectomy, the progression of symptoms stopped, and with intravenous high-dose immunoglobulin and steroid therapy, the symptoms improved to only minor numbness in the peripheral limbs as of the 18-month follow-up. As of the 2-year follow-up, there has been no cancer recurrence or metastasis. Conclusions When paraneoplastic neurological syndrome is suspected, early diagnosis and a multidisciplinary approach, including surgical treatment, are important before irreversible neurological damage occurs.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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