E-ISSN 2277-338X | ISSN 2320-4664
|Case Report|| |
Amyotropic lateral sclerosis as a para-neoplastic manifestation of gastric adenocarcinoma - A rare case report
Subrata Chakrabarti, Koushik Pan.
Motor neuron diseases(MND) have been reported as a rare paraneoplastic syndrome (PNS) of a systemic neoplasm.Amyotropic Lateral Sclerosis as a paraneoplastic manifestation of gastric carcinoma is even rarer. We present a patient with amyotrophic lateral sclerosis (ALS) in association with adenocarcinoma of stomach. A 48year old man presented with a four months history of progressive dysphagia, spastic dysarthria and marked fasciculation in his atrophic tongue. Gag reflexes were diminished bilaterally. There was significant atrophy in thenar and hypothenar areas of both hands and dorsum of both feet.Electromyography result was compatible with diffuse motor neuronopathy with active denervation.MRI brain showed classical findings of ALS. Upper GI endoscopic study showed ulcerated mucosa in body of stomach. Histological biopsy of stomach confirmed the presence of adenocarcinoma. The importance of considering a paraneoplastic syndrome in a patient with presentation of ALS is that it can lead to searching for underlying neoplasm before its apparent signs and symptoms develop and a scope to initiate treatment for primary carcinoma. Again treating the underlying neoplasm may halt or even resolve the neurologic signs and symptoms.
Motor Neuron Diseases; Amyotrophic Lateral Sclerosis; Paraneoplastic Syndrome; Gastric Adenocarcinoma
|1.Dropcho EJ. Neurological paraneoplastic syndromes; Curr Oncol Rep. 2004;6(1):26-31 [DOI via Crossref] [Pubmed] |
|2.Forsyth PA, Dalmau J, Graus F, Cwik V, Rosenblum MK, Posner JB. Motor neuron syndromes in cancer patients; Ann Neurol. 1997;41(6):722 [DOI via Crossref] [Pubmed] |
|3.Gordon PH, Rowland LP, Younger DS, Sherman WH, Hays AP, Louis ED, et al. Lymphoproliferative disorders and motor neuron disease: an update. Neurology 1997;48:1671-8. [DOI via Crossref] [Pubmed] |
|4.Turk HM, Ozet A, Kuzhan O, Komurcu F, Arpaci F, Ozturk B, et al. Paraneoplastic motor neuron disease resembling amyotrophic lateral sclerosis in a patient with renal cell carcinoma.Med Princ Pract. 2009;18(1):73-5. [DOI via Crossref] [DOI via Crossref] |
|5.Khealani BA, Qureshi R, Wasay M. Motor Neuronopathy associated with Adenocarcinoma of Esophagus. J Pak Med Assoc. 2004; 54(3) :165-6 [Pubmed] |
|6. Mehrpour M, Mohebi N, Motamed MR, Zamani F. Amyotrophic lateral sclerosis as a paraneoplastic manifestation in the neuroendocrine tumor of stomach: a case report. Acta Med Iran. 2013;51(10):724-6 [Pubmed] |