Anti-SOX1 antibody-positive paraneoplastic neurological syndrome presenting with Lambert-Eaton myasthenic syndrome and small cell lung cancer: A case report

Thorac Cancer. 2020 Feb;11(2):465-469. doi: 10.1111/1759-7714.13290. Epub 2019 Dec 27.

Abstract

Paraneoplastic neurological syndromes (PNS) are rare disorders affecting any part of the central, peripheral or autonomic nervous system that occur in association with cancer. Among cancer patients, less than 1% overall develop PNS. Anti-SOX1 antibodies' positive paraneoplastic neurological disorders are rare and are usually associated with small cell lung cancer (SCLC). Here, we report a case of a 61-year-old male patient who presented with an unusual anti-SOX1 positive PNS. The right tibialis anterior showed noticeable low-amplitude motor unit potentials and high amplitude motor potentials in electrodiagnostic study, suggesting the presence of Lambert-Eaton myasthenic syndrome (LEMS). Typical MRI and PET-CT found a hyperintense lesion with contrast enhancement in the thorax in front of 5-6 centrum of vertebrae, and thoracoscopic biopsy revealed pathological findings for SCLC. The patient underwent several lines of chemotherapy and radiotherapy and survived for 15 months after the diagnosis of SCLC.

Keywords: Anti-SOX1antibody; Lambert-Eaton myasthenic syndrome; paraneoplastic neurological syndromes; small cell lung cancer.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autoantibodies / blood*
  • Autoantibodies / immunology
  • Diagnosis, Differential
  • Humans
  • Lambert-Eaton Myasthenic Syndrome / blood
  • Lambert-Eaton Myasthenic Syndrome / complications
  • Lambert-Eaton Myasthenic Syndrome / diagnosis*
  • Lambert-Eaton Myasthenic Syndrome / immunology
  • Lung Neoplasms / blood
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / immunology
  • Male
  • Middle Aged
  • Nervous System Diseases / blood
  • Nervous System Diseases / complications
  • Nervous System Diseases / diagnosis*
  • Nervous System Diseases / immunology
  • Paraneoplastic Syndromes / blood
  • Paraneoplastic Syndromes / complications
  • Paraneoplastic Syndromes / diagnosis*
  • Paraneoplastic Syndromes / immunology
  • Prognosis
  • SOXB1 Transcription Factors / immunology*
  • Small Cell Lung Carcinoma / blood
  • Small Cell Lung Carcinoma / complications
  • Small Cell Lung Carcinoma / diagnosis*
  • Small Cell Lung Carcinoma / immunology

Substances

  • Autoantibodies
  • SOX1 protein, human
  • SOXB1 Transcription Factors