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The coexistence of myasthenia gravis and Lambert-Eaton myasthenic syndrome (LEMS) is very rare. Case report: Herein we report an 82 year old man a known case of adenocarcinoma of bladder who came with ptosis in left eye, diplopia, and dysphagia, weakness of both lower extremities and autonomic dysfunction. According to history, physical examination and para clinical work ups coexisting of myasthenia gravis and LEMS was diagnosed. Discussion: our patient is the first patient with Overlap myasthenic syndrome on the base of adenocarcinoma of bladder. The purpose of this case report is to emphasize on this fact that a patient with LEMS should be evaluate carefully for detecting underlying malignancies. Although in the most cases the origin is lung, extra pulmonary origin such as urinary system should be evaluate carefully too.

Rare Coexistence of Myasthenia Gravis and Lambert-Eaton Myasthenic Syndrome with Adenocarcinoma of the Bladder: A Case Report