[An autopsy case of carcinomatous sensory neuropathy associated with gastric adenosquamous carcinoma]

A 61-year-old man was admitted on May 1986 with complaints of hypesthesia and pain in the both legs, and of progressive difficulty in walking. Physical examination was unremarkable. On neurological examination, deep tendon reflexes were decreased in all extremities without pathological reflexes. Vibration sense was decreased severely at the medial malleolus and moderately at the anterior superior iliac spine. Joint sensation of the toes was moderately decreased. Light touch, temperature discrimination, and pinprick sensation were slightly decreased on fingers bilaterally and distal to the middle part of both legs. Muscle strength was normal. His gait was unsteady and Romberg's sign was positive. Finger to nose test and heel to knee test were mildly disturbed bilaterally. The sural nerve action potential was not elicited on electrical stimulation. Laboratory studies for malignancy showed gastric cancer. Only July 4, he underwent subtotal gastrectomy. Histologically it showed adenosquamous carcinoma. Postoperatively gait disturbance and pain in both legs improved slightly. Peak latencies of P2 of SEP following right and left posterior tibial nerve stimulation were 47. 9 msec and 48.8 msec on February 14, and 44.5 msec and 43.9 msec on October 6, 1986, respectively, and their postoperative shortening was evident. He died of multiple liver and lung metastasis of the gastric cancer in November 28, 1986. At autopsy, tumor metastasis were noted in liver, lung and perigastroduodenal and retroperitoneal lymph nodes.(ABSTRACT TRUNCATED AT 250 WORDS)