Paraneoplastic Syndrome with Intestinal Pseudo-obstruction in a Patient with Small Cell Lung Carcinoma: a Case Report and Literature Review

Overview

Journal J Int Med Res

Publisher Sage Publications

Date 2025 Jan 17

PMID 39819129

Authors

Xiao-Jun Ren

Zhao-Hong Shi

Ying-Xia Cheng

Yun Luo

Affiliations

Soon will be listed here.

Abstract

Paraneoplastic chronic intestinal pseudo-obstruction (CIPO) is a rare manifestation associated with small cell lung carcinoma and other malignancies. In this report, we present a challenging case involving a 60-year-old man with small cell lung carcinoma who developed symptoms of intestinal pseudo-obstruction, including abdominal distention, pain, and obstipation. Despite receiving extensive treatment with intravenous gamma globulin and glucocorticoids, the patient's symptoms did not improve, ultimately resulting in irreversible nervous system damage. Through a comprehensive literature review, we explore the underlying mechanisms of paraneoplastic CIPO and discuss its diagnostic and therapeutic approaches. We emphasize the significance of timely detection of related antibodies for early diagnosis and treatment of CIPO to improve patient outcomes.

References

Gagnier J, Kienle G, Altman D, Moher D, Sox H, Riley D . The CARE Guidelines: Consensus-based Clinical Case Reporting Guideline Development. Glob Adv Health Med. 2014; 2(5):38-43. PMC: 3833570. DOI: 10.7453/gahmj.2013.008. View

Rosenfeld M, Dalmau J . Update on paraneoplastic neurologic disorders. Oncologist. 2010; 15(6):603-17. PMC: 3227988. DOI: 10.1634/theoncologist.2010-0001. View

Badari A, Farolino D, Nasser E, Mehboob S, Crossland D . A novel approach to paraneoplastic intestinal pseudo-obstruction. Support Care Cancer. 2011; 20(2):425-8. DOI: 10.1007/s00520-011-1305-7. View

Di Nardo G, Karunaratne T, Frediani S, De Giorgio R . Chronic intestinal pseudo-obstruction: Progress in management?. Neurogastroenterol Motil. 2017; 29(12). DOI: 10.1111/nmo.13231. View

Graus F, Abos J, Roquer J, Mazzara R, Pereira A . Effect of plasmapheresis on serum and CSF autoantibody levels in CNS paraneoplastic syndromes. Neurology. 1990; 40(10):1621-3. DOI: 10.1212/wnl.40.10.1621. View

Sorhaug S, Steinshamn S, Waldum H . Octreotide treatment for paraneoplastic intestinal pseudo-obstruction complicating SCLC. Lung Cancer. 2005; 48(1):137-40. DOI: 10.1016/j.lungcan.2004.09.008. View

De Giorgio R, Bovara M, Barbara G, Canossa M, Sarnelli G, De Ponti F . Anti-HuD-induced neuronal apoptosis underlying paraneoplastic gut dysmotility. Gastroenterology. 2003; 125(1):70-9. DOI: 10.1016/s0016-5085(03)00664-4. View

Cerra-Franco J, Fernandez-Cruz C, Estremera-Marcial R, Pagan-Torres H, Martinez-Souss J, Toro D . Anti-Hu-Mediated Paraneoplastic Chronic Intestinal Pseudo-Obstruction Arising From Small Cell Prostate Cancer. ACG Case Rep J. 2019; 6(6):e00105. PMC: 6722348. DOI: 10.14309/crj.0000000000000105. View

Lennon V, Sas D, Busk M, Scheithauer B, Malagelada J, Camilleri M . Enteric neuronal autoantibodies in pseudoobstruction with small-cell lung carcinoma. Gastroenterology. 1991; 100(1):137-42. DOI: 10.1016/0016-5085(91)90593-a. View

10.

Graus F, Vogrig A, Muniz-Castrillo S, Antoine J, Desestret V, Dubey D . Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes. Neurol Neuroimmunol Neuroinflamm. 2021; 8(4). PMC: 8237398. DOI: 10.1212/NXI.0000000000001014. View

11.

Vogrig A, Muniz-Castrillo S, Desestret V, Joubert B, Honnorat J . Pathophysiology of paraneoplastic and autoimmune encephalitis: genes, infections, and checkpoint inhibitors. Ther Adv Neurol Disord. 2020; 13:1756286420932797. PMC: 7318829. DOI: 10.1177/1756286420932797. View

12.

De Giorgio R, Sarnelli G, Corinaldesi R, Stanghellini V . Advances in our understanding of the pathology of chronic intestinal pseudo-obstruction. Gut. 2004; 53(11):1549-52. PMC: 1774265. DOI: 10.1136/gut.2004.043968. View

13.

Graus F, Vega F, Delattre J, Bonaventura I, Rene R, Arbaiza D . Plasmapheresis and antineoplastic treatment in CNS paraneoplastic syndromes with antineuronal autoantibodies. Neurology. 1992; 42(3 Pt 1):536-40. DOI: 10.1212/wnl.42.3.536. View

14.

Antonucci A, Fronzoni L, Cogliandro L, Cogliandro R, Caputo C, De Giorgio R . Chronic intestinal pseudo-obstruction. World J Gastroenterol. 2008; 14(19):2953-61. PMC: 2712158. DOI: 10.3748/wjg.14.2953. View

15.

Blaes F . Pathogenesis, diagnosis and treatment of paraneoplastic neurologic syndromes. Expert Rev Neurother. 2021; 21(6):675-686. DOI: 10.1080/14737175.2021.1927713. View

16.

Taverna J, Babiker H, Yun S, Bishop M, Lau-Braunhut S, Meyer P . The great masquerader of malignancy: chronic intestinal pseudo-obstruction. Biomark Res. 2015; 2(1):23. PMC: 4310203. DOI: 10.1186/s40364-014-0023-y. View

17.

Lee H, Lennon V, Camilleri M, Prather C . Paraneoplastic gastrointestinal motor dysfunction: clinical and laboratory characteristics. Am J Gastroenterol. 2001; 96(2):373-9. DOI: 10.1111/j.1572-0241.2001.03454.x. View

18.

Coret F, Bosca I, Fratalia L, Perez-Griera J, Pascual A, Casanova B . Long-lasting remission after rituximab treatment in a case of anti-Hu-associated sensory neuronopathy and gastric pseudoobstruction. J Neurooncol. 2009; 93(3):421-3. DOI: 10.1007/s11060-008-9787-y. View

19.

Castaneda D, Miret R, Rajagopalan R, Castillo M, Gonzalez A, Castro F . Chronic Intestinal Pseudo-Obstruction Due to Incidentally Found Thymoma. ACG Case Rep J. 2021; 8(5):e00608. PMC: 8174544. DOI: 10.14309/crj.0000000000000608. View

20.

DiBaise J . Paraneoplastic gastrointestinal dysmotility: when to consider and how to diagnose. Gastroenterol Clin North Am. 2011; 40(4):777-86. DOI: 10.1016/j.gtc.2011.09.004. View