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• Vol.50 No.8
• CLINICA NEUROL, 50: 556−560, 2010
• Vol.50 No.8 contents

Case Report

A case of lung adenocarcinoma presenting with chorea with bilateral basal ganglial lesions on MRI

Hirohiko Saito, M.D.¹⁾²⁾, Kunitoshi Ohtsuka, M.D.³⁾, Hidenobu Takahashi, M.D.⁴⁾, Hiroyuki Miura, M.D.⁴⁾, Takeshi Taguchi, M.D.¹⁾ and Kazunori Nanri, M.D.¹⁾

¹⁾Department of Neurology, Tokyo Medical University Hachioji Medical Center
²⁾Department of Rehabilitation, Tokyo Metropolitan Health and Medical Treatment Corporation Ebara Hospital
³⁾Department of Neurosurgery, Tokyo Medical University Hachioji Medical Center
⁴⁾Department of Thoracic Surgery, Tokyo Medical University Hachioji Medical Center

The patient, a 63-year-old man, experienced the subacute onset of chorea, for which his family doctor prescribed oral haloperidol. However, the involuntary movements gradually worsened, and the patient was referred and admitted. High-signal lesions were seen in the caudate nucleus, putamen and globus pallidus bilaterally on MRI T₂-weighted and FLAIR images. Chest CT, FDG-PET and tissue biopsies also revealed that the patient had lung adenocarcinoma with multiple lymph node metastases. The patient was diagnosed as having paraneoplastic chorea associated with primary lung adenocarcinoma. Antineuronal antibodies, such as anti-CRMP-5 and anti-Yo antibodies, were absent. The patient received steroid pulse therapy, oral prednisolone therapy, and concurrent radiochemotherapy. Chorea and high-signal lesions in the corpus striatum bilaterally on MRI improved quickly, and the mediastinal lymph node swelling also improved. The patient has been stable for 3 years since the onset of his symptoms. As the prognosis of paraneoplastic chorea is relatively favorable in some patients, it should be considered in the differential diagnosis of patients with chorea.
Full Text of this Article in Japanese PDF (666K)

(CLINICA NEUROL, 50: 556−560, 2010)
key words: paraneoplastic neurologic syndrome, chorea, involuntary movement, lung adenocarcinoma, MRI

(Received: 28-Oct-09)