Premium
Paraneoplastic cerebellar degeneration and lambert‐eaton myasthenia in a patient with merkel cell carcinoma and voltage‐gated calcium channel antibodies
Author(s) -
Pavolucci Lucia,
Giannini Giulia,
Giannoccaro Maria Pia,
Foschini Maria Pia,
Lang Bethan,
Avoni Patrizia,
Tinuper Paolo,
Vincent Angela,
Liguori Rocco
Publication year - 2017
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.25530
Subject(s) - merkel cell carcinoma , lambert eaton myasthenic syndrome , medicine , paraneoplastic cerebellar degeneration , pathology , cerebellar degeneration , small cell carcinoma , carcinoma , ataxia , myasthenia gravis , antibody , immunology , autoantibody , psychiatry
Merkel cell carcinoma is a rare cutaneous, aggressive tumor. Although it shares many neuroendocrine features with small cell lung carcinoma, it has only occasionally been reported with paraneoplastic neurological syndromes. Methods A healthy 67‐year‐old man developed acute ataxia, vertigo, and nausea. Subsequently he also developed dysarthria, diplopia, xerostomia, fatigability and progressive anorexia. He underwent a full diagnostic workup and was found to have a high titer of voltage‐gated calcium channel antibodies in serum and cerebrospinal fluid, neurophysiological findings compatible with Lambert‐Eaton myasthenia and neurological signs compatible with cerebellar degeneration. Results A positron emission tomography study revealed a hypermetabolic lesion in the axilla, subsequently biopsied and consistent with Merkel cell carcinoma. Conclusions In most previous reports, neurological symptoms preceded the Merkel cell carcinoma diagnosis, and the primary localization was in lymph nodes. This tumor should be considered in patients with paraneoplastic syndrome, and particularly Lambert‐Eaton myasthenia after exclusion of small cell lung carcinoma. Muscle Nerve 56 : 998–1000, 2017