Paraneoplastic Limbic Encephalitis in a Human Epidermal Growth Factor Receptor-2-positive Gastric Cancer Patient Treated with Trastuzumab-combined Chemotherapy: A Case Report and Literature Review

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  • Uneno Yu
    Department of Clinical Oncology, Kyoto University Hospital, Japan
  • Yokoyama Akira
    Department of Clinical Oncology, Kyoto University Hospital, Japan
  • Nishikawa Yoshitaka
    Department of Clinical Oncology, Kyoto University Hospital, Japan
  • Funakoshi Taro
    Department of Clinical Oncology, Kyoto University Hospital, Japan
  • Ozaki Yoshinao
    Department of Clinical Oncology, Kyoto University Hospital, Japan
  • Aoyama Ikuo
    Department of Clinical Oncology, Kyoto University Hospital, Japan
  • Baba Kiichiro
    Department of Clinical Oncology, Kyoto University Hospital, Japan
  • Yamaguchi Daisuke
    Department of Gastrointestinal Oncology, National Cancer Center Hospital East, Japan
  • Morita Shuko
    Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
  • Mori Yukiko
    Department of Clinical Oncology, Kyoto University Hospital, Japan
  • Kanai Masashi
    Department of Clinical Oncology, Kyoto University Hospital, Japan
  • Kinoshita Hisanori
    Department of Neurology, Kyoto University Hospital, Japan
  • Inoue Takeshi
    Department of Neurology, Kyoto University Hospital, Japan
  • Sawamoto Nobukatsu
    Department of Neurology, Kyoto University Hospital, Japan
  • Matsumoto Riki
    Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Japan
  • Matsumoto Shigemi
    Department of Clinical Oncology, Kyoto University Hospital, Japan
  • Muto Manabu
    Department of Clinical Oncology, Kyoto University Hospital, Japan

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Abstract

<p>Paraneoplastic neurological syndromes (PNSs) are rare nervous system dysfunctions in cancer patients, which are primarily observed with small-cell lung cancer, gynecological cancer, and thymoma. We herein present an uncommon case of PNS in an anti-Hu antibody-positive patient with human epidermal growth factor receptor (HER)-2-positive gastric cancer (GC), who developed limbic encephalitis and a worsening cognitive function. Trastuzumab-combined chemotherapy was initiated and appeared to be partially effective for controlling the neurological symptoms and tumor volume. Chemotherapy failure eventually led to uncontrollable neurological symptoms. This is the first case demonstrating that trastuzumab-combined chemotherapy may be effective for controlling neurological symptoms of PNS in HER2-positive GC patients. </p>

Journal

  • Internal Medicine

    Internal Medicine 55 (18), 2605-2609, 2016

    The Japanese Society of Internal Medicine

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