An elderly case of paraneoplastic anti-NMDA receptor encephalitis associated with large cell neuroendocrine carcinoma of the lung

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2024年7月12日

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Masamitsu Naka,
Atsushi Inaba,
Hana Miyasaka,
Keisuke Suzue,
Junichi Ishigaki,
Hideki Shibuya,
Kei Hara,
Nobuya Ohishi,
Yusuke Sugiyama,
Yasushi Shiio,
Ryosuke Tajiri,
Yukiko Kishida,
Tasuku Ishihara,
Akihiro Yugeta

摘要

Background

Recent studies have suggested that N-methyl-D-aspartate (NMDA) receptors are involved in the cell proliferation in several tumors. However, there have been no reports demonstrating the expression of NR1 subunit of the NMDA receptor in large cell neuroendocrine carcinoma (LCNEC).

Case presentation

Here, we report the first elderly case of paraneoplastic anti-NMDA receptor encephalitis associated with LCNEC of the lung with NR1 expression. Of note, NR1 subunit expression in the tumor cells of the present case was confirmed by immunohistochemistry (IHC). Radiation therapy and immunotherapies, such as corticosteroids and intravenous immunoglobulin (IVIG), shrank the tumors and improved neurological symptoms in the present case. Additionally, we also confirmed the expression of NR1 in the tumor cells obtained from three other cases with LCNEC of the lung at our hospital by IHC.

Conclusion

Our IHC results indicate that LCNEC generally expresses NR1 subunit and NMDA receptor may be involved in the tumor development and growth.