Roy El Koussa¹*, Matilda Abu-Saba¹, Vijayta Geeta Bansal-Kapuria², William Graft³, Vibhav Bansal⁴

¹Mercyhealth Internal Medicine Residency, Javon Bea Hospital, Rockford, Illinois, USA
²Advocate Condell Medical Center, Libertyville, Illinois, USA
³University of Illinois College of Medicine Rockford, Rockford, Illinois, USA
⁴Mercyhealth Comprehensive Stroke Center, Javon Bea Hospital, Rockford, Illinois, USA

*Corresponding Author: Roy El Koussa, Mercyhealth Internal Medicine Residency, Javon Bea Hospital, Rockford, Illinois, USA.

Received: August 20,2022; Published: September 15, 2022

Abstract

Background: Small cell carcinoma (SCC) is a neuroendocrine neoplasm most commonly arising from the lungs. Extrapulmonary SCC is a rare pathology that have been previously described in the literature, namely GI and GU tracts. The onconeural antibody anti-neuronal nuclear antibody type I (anti-Hu) is highly specific for SCC of the lung and, when found in the serum or CSF of a patient, warrants oncological workup to look for an occult malignancy.

Case Presentation: Here, we report the case of a 78-year-old female that presented with short-term memory loss, confusion, and altered mental status concerning for paraneoplastic neurologic syndrome. She underwent extensive diagnostic workup that revealed a positive paraneoplastic panel. Subsequent imaging studies led to the identification of a primary adrenal SCC.

Conclusion: To our knowledge, this is the first report of a primary adrenal SCC associated with anti-Hu antobodies and the development of limbic encephalitis. This case highlights the importance of a positive paraneoplastic panel in the diagnostic considerations and the potential ubiquity of the well characterized onconeural antibodies.

Keywords: Small Cell Carcinoma; Adrenal Carcinoma; Onconeural Antibodies; Anti-Hu; Limbic Encephalitis

References

1. Berniker Abigail V., et al. “Extrapulmonary small cell carcinoma: imaging features with radiologic-pathologic correlation”. Radiographics : A Review Publication of the Radiological Society of North America, Inc1 (2015): 152-163.
2. Frazier Shellaine R., et al. “The pathology of extrapulmonary small cell carcinoma”. Seminars in Oncology1 (2007): 30-38.
3. Budhram Adrian., et al. “Diagnosing autoimmune limbic encephalitis”. CMAJ : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne19 (2019): E529-E534.
4. Monstad Sissel Evy., et al. “Onconeural antibodies in sera from patients with various types of tumours”. Cancer Immunology, Immunotherapy : CII11 (2009): 1795-800.
5. Graus, Francesc., et al. “A clinical approach to diagnosis of autoimmune encephalitis”. The Lancet. Neurology4 (2016): 391-404.
6. Asztely F and E Kumlien. “The diagnosis and treatment of limbic encephalitis”. Acta Neurologica Scandinavica 6 (2012): 365-375.

Citation

Citation: Roy El Koussa., et al. “Primary Adrenal Small Cell Carcinoma Associated with Anti-Hu Positive Limbic Encephalitis: A Case Report”. Acta Scientific Neurology 5.10 (2022): 03-05.

Copyright

Copyright: © 2022 Roy El Koussa, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.