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Shin, Kim, Lim, Noh, Choi, Kim, Lee, Park, and Park: A Case of Paraneoplastic Limbic Encephalitis Associated with Primary Adenocarcinoma of Lung
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 63(4): 382-386.

Published online: 31 October 2007

DOI: https://doi.org/10.4046/trd.2007.63.4.382

A Case of Paraneoplastic Limbic Encephalitis Associated with Primary Adenocarcinoma of Lung

Hyun Jong Shin, M.D.1, Hyun Soo Kim, M.D.1, Keum Nam Lim, M.D.1, U Seok Noh, M.D.1, Jung Hye Choi, M.D.1, In Soon Kim, M.D.1, Young Yeul Lee, M.D.1, Byeong Bae Park, M.D.1, Dong Woo Park, M.D.2

1Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea.

2Department of Radiology, Hanyang University Guri Hospital, Guri, Korea.

Address for correspondence: Jung Hye Choi, M.D. Department of Internal Medicine, Hanyang University Guri Hospital, 249-1, Gyomun-dong, Guri-si, Gyunggi-do 471-710, Korea. Phone: 82-31-560-2236, Fax: 82-31-553-7369, jhcmd@hanyang.ac.kr

Received 31 August 2007       Accepted 28 September 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Paraneoplastic limbic encephalitis is a rare disorder that is characterized by personality changes, irritability, depression, seizures, memory loss and dementia, and is commonly associated with small cell lung cancer. The cause is unknown but it is believed to be an autoimmune disorder that develops secondary to a carcinomatous process.
We report a patient with the clinical feature consistent with limbic encephalitis. A 64-year-old women developed disorientation, memory loss and general weakness. She was diagnosed with NSCLC (adenocarcinoma) with a brain metastasis 1 year earlier and was treated with radiation and chemotherapy. Although the lung mass and brain metastatic lesions had improved, the brain T2-weighted MRI showed high signal intensity in the right temporal region. This lesion consisted of with limbic encephalitis and was negative to the other viral and immune markers. The patient's symptoms did not improve after steroid treatment. Our case demonstrated that a NSCLC (adenocarcinoma) also can be associated with paraneoplastic limbic encephalitis.

Keywords: Paraneoplastic limbic encephalitis, Non-small cell lung cancer

Figures and Tables

Figure 1
Chest CT shows non-small cell lung cancer at Right lower lobe (A). Brain MRI shows brain metastasis (B).
trd-63-382-g001
Figure 2
Chest CT shows decreased size of non-small cell lung cancer at Right lower lobe (A). Brain MRI shows decreased sizes of brain metastasis (B).
trd-63-382-g002
Figure 3
Brain MRI finding. T1 weighted image shows low signal density in right temporal lobe (A). T2 weighted image shows high signal intensity in right temporal lobe (B).
trd-63-382-g003

References

1. Corsellis JA, Goldberg GJ, Norton AR. "Limbic encephalitis" and its association with carcinoma. Brain. 1968. 91:481–496.
2. Cakirer S. Paraneoplastic limbic encephalitis: case report. Comput Med Imaging Graph. 2002. 26:55–58.
3. Gultekin SH, Rosenfeld MR, Voltz R, Eichen J, Posner JB, Dalmau J. Paraneoplastic limbic encephalitis: neurological symptoms, immunologic findings and tumor association in 50 patients. Brain. 2000. 123:1481–1494.
4. Dalmau J, Bataller L. Clinical and immunological diversity of limbic encephalitis: a model for paraneoplastic neurologic disorders. Hematol Oncol Clin North Am. 2006. 20:1319–1335.
5. Vedeler CA, Antoine JC, Giometto B, Graus F, Grisold W, Hart IK, et al. Management of paraneoplastic neurological syndromes. Eur J Neurol. 2006. 13:682–690.
6. Cho TY, Kim YJ, Lee BI, Huh K. A case of limbic encephalitis associated with small cell lung cancer about diagnostic MRI findings. J Korean Neurol Assoc. 1994. 12:338–342.
7. Cho HJ, Jo JW. A case of paraneoplastic limbic encephalitis associated with immature teratoma. J Korean Neurol Assoc. 2003. 21:647–650.
8. Seo KY, Hur SY, Kim SJ, Park TC, Bae SN, Han GT, et al. A Clinicopathologic study of immature teratoma of the ovary. Korean J Obstet Gynecol. 2004. 47:2389–2396.
9. Hiasa Y, Kunishige M, Mitsui T, Kondo S, Kuriwaka R, Shigekiyo S, et al. Complicated paraneoplastic neurological syndromes: a report of two patients with small cell or non-small cell lung cancer. Clin Neurol Neurosurg. 2003. 106:47–49.
10. Darnell RB, Posner JB. Paraneoplastic syndromes involving the Nervous system. N Engl J Med. 2003. 349:1543–1554.
11. Kim KK. Paraneoplastic syndrome. J Korean Neurol Assoc. 2002. 20:215–222.
12. Aydiner A, Gurvit H, Baral I. Paraneoplastic limbic encephalitis with immature ovarian teratoma. J Neurooncol. 1998. 37:63–66.
13. Messori A, Lanza C, Serio A, Salvolini U. Resolution of limbic encephalitis with detection and treatment of lung cancer: clinicalradiological correlation. Eur J Radiol. 2003. 45:78–80.
14. Voltz R. Paraneoplastic neurological syndromes: an update on diagnosis, pathogenesis, and therapy. Lancet Neurol. 2002. 1:294–305.
15. Pittock S, Kryzer TJ, Lennon VA. Paraneoplastic antibodies coexist and predict cancer, not neurological syndrome. Ann Neurol. 2004. 56:715–719.
16. Vernino S, Lennon VA. New Putkinje cell antibody(PCA-2): marker of lung cancer-related neurological autoimmunity. Ann Neurol. 2000. 47:297–305.
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