Paraneoplastic cerebellar degeneration and lambert‐eaton myasthenia in a patient with merkel cell carcinoma and voltage‐gated calcium channel antibodies. Issue 5 (23rd March 2017)

• Record Type: Journal Article
• Authors: Pavolucci, Lucia; Giannini, Giulia; Giannoccaro, Maria Pia; Foschini, Maria Pia; Lang, Bethan; Avoni, Patrizia; Tinuper, Paolo; Vincent, Angela; Liguori, Rocco
• Is Part Of: Muscle & nerve. Volume 56:Issue 5(2017)
• Page Start: 998
• Page End: 1000
• Publication Date: 2017-03-23
• Subjects: cerebellar degeneration -- Lambert‐Eaton myasthenia -- Merkel cell carcinoma -- neuroendocrine neoplasm -- paraneoplastic syndrome -- voltage‐gated calcium channel antibodies; Neuromuscular diseases -- Periodicals; Muscles -- Periodicals; Nerves -- Periodicals; 616.74
• DOI: 10.1002/mus.25530
• Languages: English
• ISSNs: 0148-639X

Abstract

ABSTRACT: Introduction: 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