[Brain metastasis of lung cancer with Eaton-Lambert syndrome--case report]

A case of brain metastasis of lung cancer with Eaton-Lambert syndrome (ELS) is reported. A 45-year-old male was admitted to the Department of Surgery in Kurume University Hospital on November 13, 1985, complaining of general fatigue. On admission, neurological examination revealed diplopia and fatigue of the extremities. The electromyogram (EMG) showed the waning phenomenon in low frequency repetitive stimulation (2Hz) and the waxing phenomenon in high frequency repetitive stimulation (10Hz, 20Hz). His clinical symptoms, radiological findings and EMG findings demonstrated lung cancer with ELS. Left pulmonary lobectomy with lymphnode dissection of the anterior mediastinum and pulmonary hilus was performed on December 4. Intraoperatively, the tumor was strongly adherent to a medium lymphnode. The patient experienced complete relief symptoms due to ELS. Histological examination disclosed a small cell carcinoma without lymphnode metastasis. He was discharged without any neurological deficits following chemotherapy on February 27, 1986. He was readmitted to the Department of Neurosurgery on August 29, 1986, because of the development of nausea and vomiting. Neurological examination demonstrated no abnormalities except for choked disc in the bilateral ocular fundi. The computed tomography scan revealed a metastatic brain tumor with a mural nodule and cyst. The tumor was totally removed on September 2. Histological examination revealed a typical appearance of small cell carcinoma. He followed a satisfactory postoperative course. He was discharged following radiation therapy on November 2, 1986, and was followed as an outpatient. He has no problem in daily life since then. Though the patient had an expanding metastatic brain tumor from lung cancer after the first operation, he experienced no symptoms due to ELS.(ABSTRACT TRUNCATED AT 250 WORDS)