| Screening for tumours in paraneoplastic syndromes: report of an EFNS task force. | |
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MedLine Citation:
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PMID: 20880069 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: paraneoplastic neurological syndromes (PNS) almost invariably predate detection of the malignancy. Screening for tumours is important in PNS as the tumour directly affects prognosis and treatment and should be performed as soon as possible. OBJECTIVES: an overview of the screening of tumours related to classical PNS is given. Small cell lung cancer, thymoma, breast cancer, ovarian carcinoma and teratoma and testicular tumours are described in relation to paraneoplastic limbic encephalitis, subacute sensory neuronopathy, subacute autonomic neuropathy, paraneoplastic cerebellar degeneration, paraneoplastic opsoclonus-myoclonus, Lambert-Eaton myasthenic syndrome (LEMS), myasthenia gravis and paraneoplastic peripheral nerve hyperexcitability. METHODS: many studies with class IV evidence were available; one study reached level III evidence. No evidence-based recommendations grade A-C were possible, but good practice points were agreed by consensus. RECOMMENDATIONS: the nature of antibody, and to a lesser extent the clinical syndrome, determines the risk and type of an underlying malignancy. For screening of the thoracic region, a CT-thorax is recommended, which if negative is followed by fluorodeoxyglucose-positron emission tomography (FDG-PET). Breast cancer is screened for by mammography, followed by MRI. For the pelvic region, ultrasound (US) is the investigation of first choice followed by CT. Dermatomyositis patients should have CT-thorax/abdomen, US of the pelvic region and mammography in women, US of testes in men under 50 years and colonoscopy in men and women over 50. If primary screening is negative, repeat screening after 3-6 months and screen every 6 months up till 4 years. In LEMS, screening for 2 years is sufficient. In syndromes where only a subgroup of patients have a malignancy, tumour markers have additional value to predict a probable malignancy. |
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Authors:
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M J Titulaer; R Soffietti; J Dalmau; N E Gilhus; B Giometto; F Graus; W Grisold; J Honnorat; P A E Sillevis Smitt; R Tanasescu; C A Vedeler; R Voltz; J J G M Verschuuren; |
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Publication Detail:
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Type: Journal Article; Practice Guideline Date: 2010-09-29 |
Journal Detail:
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Title: European journal of neurology : the official journal of the European Federation of Neurological Societies Volume: 18 ISSN: 1468-1331 ISO Abbreviation: Eur. J. Neurol. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-16 Completed Date: 2011-05-25 Revised Date: 2012-05-11 |
Medline Journal Info:
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Nlm Unique ID: 9506311 Medline TA: Eur J Neurol Country: England |
Other Details:
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Languages: eng Pagination: 19-e3 Citation Subset: IM |
Affiliation:
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Department of Neurology, Leiden University Medical Center, Leiden, Netherlands. m.j.titulaer@lumc.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Antibodies
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immunology Early Detection of Cancer / methods* Female Humans Male Neoplasms / diagnosis*, immunology Paraneoplastic Syndromes / diagnosis*, immunology |
| Grant Support | |
ID/Acronym/Agency:
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R01 CA089054-02/CA/NCI NIH HHS; R01 NS077851/NS/NINDS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antibodies |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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