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INTRODUCTION: Merkel cell carcinoma is a rare cutaneous, aggressive tumor. Although it shares many neuroendocrine features with small cell lung carcinoma, it has only occasionally been reported with paraneoplastic neurological syndromes. METHODS: A healthy 67-year-old man developed acute ataxia, vertigo, and nausea. Subsequently he also developed dysarthria, diplopia, xerostomia, fatigability and progressive anorexia. He underwent a full diagnostic workup and was found to have a high titer of voltage-gated calcium channel antibodies in serum and cerebrospinal fluid, neurophysiological findings compatible with Lambert-Eaton myasthenia and neurological signs compatible with cerebellar degeneration. RESULTS: A positron emission tomography study revealed a hypermetabolic lesion in the axilla, subsequently biopsied and consistent with Merkel cell carcinoma. CONCLUSIONS: In most previous reports, neurological symptoms preceded the Merkel cell carcinoma diagnosis, and the primary localization was in lymph nodes. This tumor should be considered in patients with paraneoplastic syndrome, and particularly Lambert-Eaton myasthenia after exclusion of small cell lung carcinoma. Muscle Nerve 56: 998-1000, 2017.

Original publication

DOI

10.1002/mus.25530

Type

Journal article

Journal

Muscle Nerve

Publication Date

11/2017

Volume

56

Pages

998 - 1000

Keywords

Lambert-Eaton myasthenia, Merkel cell carcinoma, cerebellar degeneration, neuroendocrine neoplasm, paraneoplastic syndrome, voltage-gated calcium channel antibodies, Aged, Autoantibodies, Calcium Channels, N-Type, Carcinoma, Merkel Cell, Humans, Lambert-Eaton Myasthenic Syndrome, Lung Neoplasms, Male, Paraneoplastic Cerebellar Degeneration