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J Thorac Cardiovasc Surg 2001;121:1005-1006
© 2001 The American Association for Thoracic Surgery

Brief Communications

Lambert-Eaton myasthenic syndrome associated with an anterior mediastinal small cell carcinoma

Takeshi Oyaizu, MDa, Yoshinori Okada, MDa, Motoyasu Sagawa, MDa, Kazuo Yamakawa, MDb, Hiroshi Kuroda, MDb, Kazuo Fujihara, MDb, Yasuto Itoyama, MDb, Tatsuo Tanita, MDa, Masakatsu Motomura, MDc, Takashi Kondo, MDa, Sendai and Nagasaki, Japan

From the Department of Thoracic Surgery,a Institute of Development, Aging and Cancer, Tohoku University, the Department of Neurology,b Tohoku University School of Medicine, Sendai, Japan, and The First Department of Internal Medicine,c Nagasaki University School of Medicine, Nagasaki, Japan.

Received for publication Aug 16, 2000. Accepted for publication Sept 14, 2000. Address for reprints: Takeshi Oyaizu, MD, Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan (E-mail: oyaizu@idac.tohoku.ac.jp).

Approximately 60% of patients with Lambert-Eaton myasthenic syndrome (LEMS) have small cell lung carcinoma (SCLC).Go 1 However, LEMS is infrequently associated with carcinomas in other sites. We present here a rare case of LEMS with an anterior mediastinal small cell carcinoma in a patient who had no pulmonary lesion detected.

Clinical summary

A 46-year-old man was admitted to a local hospital because of fatigability, muscle weakness of the extremities, and double vision. On the basis of a tentative diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy, he was treated with oral prednisolone (15 mg every other day) and 8 sessions of plasmapheresis; however, the symptoms were only temporarily relieved. Six months later, he was referred to us. On examination, bilateral ptosis, facial and bulbar paresis, proximal-dominant limb muscle atrophy, and generalized areflexia were observed. His grip was 20 kg at most. No lymph node was palpable in the patient's neck or axillae. Electrodiagnostic study demonstrated abnormally low-amplitude compound muscle . . . [Full Text of this Article]






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