Paraneoplastic syndrome – An unusual presentation

Volume 8, Issue 3, June 2023     |     PP. 172-175      |     PDF (102 K)    |     Pub. Date: May 4, 2023
DOI: 10.54647/cm321067    76 Downloads     1882 Views  

Author(s)

Dr Tahir Abbas, Saskatchewan Cancer Agency-Saskatoon Cancer Centre, University of Saskatchewan, Saskatoon, SK S7N4H4, Canada; Regina, SK S4T7T1, Canada
Dr Syed Noor, Saskatchewan Cancer Agency-Saskatoon Cancer Centre, University of Saskatchewan, Saskatoon, SK S7N4H4, Canada; Regina, SK S4T7T1, Canada

Abstract
Paraneoplastic visual syndromes are rare group of disorders due to immune mediated pathogenesis. Paraneoplastic optic neuropathy is predominantly bilateral and present with progressive painless visual loss. In our case report, 63-year-old woman presents with sequential bilateral loss of vision and on investigation was found to have adenocarcinoma of the lung. Treatment with concomitant chemotherapy and immunotherapy resulted in significant stability in her vision. She had finger counting in the left and visual acuity for the right eye was 400/20. She also noted deranged color perception. Her neurological examination was unremarkable. The cranial nerves V1-V3 were intact, tongue was midline without any fasciculation . She did not had any facial asymmetry and Romberg’s test was negative. Initial CT scan did not showed any intracranial pathology. On PET scan from June 2021 showed intensely avid 1.7 x 2.9 cm right upper lobe uptake with SUV of 7.

Keywords
Paraneoplastic usual case, Paraneoplastic visual syndromes, Paraneoplastic optic neuropath, chemotherapy and immunotherapy to treat visual paraneoplastic syndrome

Cite this paper
Dr Tahir Abbas, Dr Syed Noor, Paraneoplastic syndrome – An unusual presentation , SCIREA Journal of Clinical Medicine. Volume 8, Issue 3, June 2023 | PP. 172-175. 10.54647/cm321067

References

[ 1 ] Heineman s, Zabel P,HanberHP. Paraneoplastic syndrome in the lung cancer. Cancer Ther 2008; 6: 687.
[ 2 ] G’amezBJ ,DelucasMDG, RodriguezMG, Cancer De Pulmonary syndrome Paraneoplasicos Annals of Internal Medicine with 2001;18-440
[ 3 ] HonnartJ,AntonieJC, paraneoplastic neurologic syndrome.Orphanet J Rare disease 2007; 2:22 (PMC pre article)(PubMed)
[ 4 ] rahimy E,Sarraf D. paraneoplastic retinopathy and optic neuropathy. Survey Ophth 2013; 58: 430-458.
[ 5 ] Alabduljalil T,Behbehani R. paraneoplastic in Neuro-Ophthalmology. Current opinions in Ophthalmology 2007;18 463-for469.
[ 6 ] Darnell RB,Posner JB. Paraneoplastic syndrome involving the nervous system. NEJM 2003; 349: 1543-1554.
[ 7 ] DamekDM. Paraneoplastic retinopathy/optic neuropathies. Current treatment options Neurol. 2005;7(1): 57-67.
[ 8 ] Subhadara C,Dudek AZ,RathPP. Improvement in the visual field in the patient with melanoma associated neuropathy treated with intravenous immunoglobulins. J. Neuro-Ophthalmology 2008; 28(1) 23-26
[ 9 ] Chan JW. Paraneoplastic neuropathy synoptic neuropathies. Survey of ophthalmology 2003; 48(1) 12-38.