Paraneoplastic Cerebellar Degeneration Successfully Treated with Intravenous Immunoglobulin in a Small Cell Lung Cancer Patient with Limited Disease

Abstract

Background. There is no established treatment for paraneoplastic cerebellar degeneration (PCD). Systemic chemotherapy is mainly performed for treating PCD, but is generally ineffective. Various treatments for PCD have been reported. Case. A 63-year-old Japanese man was admitted because of dizziness and a drifting sensation. He was treated with anticoagulant agents, but without effect. Then he was transferred to our hospital for further examinations. Chest X-ray film and computed tomography (CT) revealed mediastinal lymphadenopathy. Endobronchial ultrasonography-guided transbronchial needle aspiration cytology from an enlarged mediastinal lymph node revealed small cell carcinoma, therefore he was diagnosed as having small cell lung cancer (cTxN2M0, limited disease) with PCD. Concurrent systemic chemotherapy (CE: carboplatin + etoposide) and mediastinal radiotherapy were performed, but his neurological symptoms did not respond to treatment. Intravenous immunoglobulin (IVIG) therapy was applied 19 days after the start of systemic chemotherapy, and his neurological symptoms gradually improved. Conclusion. Early application of IVIG treatment may lead to an improvement of PCD.