Cases reported "Paraneoplastic Syndromes"

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11/25. Myokymic syndrome with impaired muscular relaxation: further evidence of a possible paraneoplastic genesis.

    A case of concomitant myokymia with impaired muscular relaxation and hypertrophic osteoarthropathy associated with the presence of two separate lung malignancies is described. Both the neurological syndrome and osteoarticular disorder significantly improved after surgical removal of the lung cancers. The possibility that common mechanisms may underlie these two tumour-related disorders is also discussed.
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ranking = 1
keywords = osteoarthropathy
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12/25. A palmar dermatosis linked to occult carcinoma of the upper thorax, head and neck: Bazex's syndrome and tripe palm.

    An unusual, persistent, corregated-to-honeycombed thickening of the palms accompanied by tenderness around the fingernails was found to be a cutaneous marker for internal malignancy. This combination of signs and symptoms has been reported under two clinical entities: Bazex's syndrome and tripe palm. This paraneoplastic syndrome is of interest to head and neck surgeons due to the location of the primary tumor, the site of metastatic disease, and the ability to cure the cutaneous disease by surgical removal of the primary tumor. In our patient, a squamous cell carcinoma of the lung not detectable on chest x-ray presented as a cervical mass accompanied by cutaneous changes on the palms and fingernails. Recognition of the relationship of the dermatologic changes to malignancy of a specific body region eventually led to the detection of the primary tumor. The characteristics of these paraneoplastic syndromes were reviewed in this report.
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ranking = 0.0033534023127209
keywords = finger
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13/25. Paraneoplastic degeneration of the substantia nigra with dystonia and parkinsonism.

    A 42-year-old woman suffered unexplained weight loss followed by action tremor and difficulty initiating gait. Three months after onset of symptoms, infiltrating ductal carcinoma of the breast, metastatic to liver and lymph nodes, was diagnosed and treated briefly with cyclophosphamide, methotrexate, and 5-flourouracil (5FU). Severe symmetric action and postural tremor with a myoclonic component developed, with minimal rest tremor, severe dysarthria and dysphagia, small-stepped and slightly ataxic gait progressing to a bedbound state, and severe widespread dystonic posturing. The latter began as a typical parkinsonian posture of trunk and upper extremities and progressed to a fixed and painful flexion of the elbows and wrists and extension of fingers and neck. Sinemet, anticholinergics, baclofen, diazepam, and plasmapheresis gave no benefit. The patient died of complications of immobility 5 months after neurologic symptom onset. autopsy revealed many pigment-laden macrophages in substantia nigra and moderate loss of pigmented neurons. inflammation, lewy bodies, and tumor were absent. Cerebellar purkinje cells were moderately depleted. Mild neuronal loss and gliosis were present in globus pallidus and cerebellar cortex. Stains for anti-human IgG, IgM, kappa, and lambda were negative. This, to our knowledge, is the first report of paraneoplastic degeneration of substantia nigra or paraneoplastic parkinsonism.
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ranking = 0.0016767011563604
keywords = finger
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14/25. Hypertrophic osteoarthropathy, cutaneous vasculitis, and mixed-type cryoglobulinemia in a patient with nasopharyngeal carcinoma.

    We describe a 27-year-old woman with a primary nasopharyngeal carcinoma who developed hypertrophic osteoarthropathy and cutaneous vasculitis. Her serum contained antibodies to Epstein-Barr virus and U1 RNP antigens. Cryoproteins isolated from her serum contained antibodies to U1 RNP and a protein with a molecular weight of 32 kd which reacted specifically with antibodies to U1 RNP. HLA typing revealed HLA-B7 and DR1; these have been reported to be increased in Japanese patients with rheumatic diseases who have autoantibodies to U1 RNP. These findings indicate that some features of the paraneoplastic syndrome in this patient might have been caused by immune complexes, part of which were formed by specific autoantibodies produced under genetically controlled conditions of immune responsiveness.
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ranking = 5
keywords = osteoarthropathy
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15/25. Acrokeratosis paraneoplastica (Bazex' syndrome).

    A 63-year-old man had acrokeratosis paraneoplastica (Bazex' syndrome) characterized by violaceous erythema and scaling of the fingers, toes, nose, and aural helices. Severe nail dystrophy was present. Extensive examination of the patient for malignant neoplasms a few months after the initial appearance of the skin changes disclosed no abnormalities, but one year after onset, an epidermoid carcinoma of the lung was found.
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ranking = 0.0016767011563604
keywords = finger
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16/25. Hypertrophic pulmonary osteoarthropathy heralding relapse of lymphoepithelioma.

    Hypertrophic pulmonary osteoarthropathy is an uncommon paraneoplastic syndrome occasionally associated with nasopharyngeal lymphoepitheliomas. We treated two patients with previously diagnosed lymphoepitheliomas in whom hypertrophic pulmonary osteoarthropathy preceded the recognition of pulmonary metastases. Both patients' disabling arthritic syndromes resolved with effective therapy directed at their neoplasms.
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ranking = 6
keywords = osteoarthropathy
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17/25. Multiple telangiectases preceding the appearance of undifferentiated bronchogenic carcinoma.

    A patient with undifferentiated bronchogenic carcinoma, which was preceded by skin manifestations, namely telangiectases on the palms, soles, fingers, toes, lips and tongue, is described. It is possible that these multiple vascular lesions are one of the cutaneous markers of internal malignancy.
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ranking = 0.0016767011563604
keywords = finger
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18/25. Tripe palms: a cutaneous marker of internal malignancy.

    Tripe palms is a distinctive paraneoplastic cutaneous sign which is frequently associated with internal malignancy, specially carcinomas of the lung and stomach. We describe a patient with ovary carcinoma who showed a curious rugose thickening of the palms with accentuation of the normal dermatoglyphic ridges. The lesions were a specially prominent on the fingertips. The patient also showed classical acanthosis nigricans in the axillae and groin. The soles were spared. Histopathologic findings in palmar lesions consisted of an undulant epidermis, with hyperkeratosis, acanthosis, and papillomatosis. Excision of the ovary carcinoma was followed by complete regression of the cutaneous lesions. We review the literature about tripe palms and discuss the relationship between this striking cutaneous manifestation and internal malignancy.
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ranking = 0.0016767011563604
keywords = finger
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19/25. Non-small-cell lung cancer with multiple paraneoplastic syndromes.

    We describe the case of a patient with multiple paraneoplastic syndromes, six in total, associated with a non-small-cell cancer of the lung. In this single patient we found hypertrophic pulmonary osteoarthropathy, hyperkeratosis of palms and soles, erythema annulare centrifugum, syndrome of inappropriate secretion of antidiuretic hormone (SIADH), and ectopic andrenocorticotrophic hormone (ACTH) and calcitonin production.
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ranking = 1
keywords = osteoarthropathy
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20/25. Bazex syndrome (acrokeratosis paraneoplastica).

    A 67 year old woman with an extensive oropharyngeal carcinoma developed acrokeratosis paraneoplastica. She suffered severe pain in the fingers and toes and experienced some symptomatic relief with psoralen ultraviolet A therapy.
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ranking = 0.0016767011563604
keywords = finger
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