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[Paraneoplastic gastroparesis]

T Berghmans1, W Musch, D Brenez

  • 1Service de Médecine interne, Centre hospitalier Joseph Bracops, Bruxelles.

Revue Medicale De Bruxelles
|November 1, 1993
PubMed
Summary
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Paraneoplastic gastroparesis, a rare complication of breast cancer, caused severe vomiting due to delayed gastric emptying. Treatment combining chemotherapy and cisapride resolved both the cancer and digestive symptoms.

Area of Science:

  • Oncology
  • Gastroenterology
  • Neurology

Background:

  • Paraneoplastic syndromes can manifest with diverse gastrointestinal symptoms.
  • Gastroparesis, characterized by delayed gastric emptying, can be idiopathic or secondary to various conditions.
  • Breast cancer, while typically associated with other paraneoplastic phenomena, can rarely present with gastrointestinal dysfunction.

Observation:

  • A 53-year-old woman presented with intractable vomiting and was diagnosed with delayed gastric emptying, indicative of gastroparesis.
  • No obstructive gastric pathology was identified, and no typical causes for gastroparesis were found.
  • The patient had bilateral untreated breast cancer, leading to the suspicion of a paraneoplastic etiology.

Findings:

  • The patient was diagnosed with paraneoplastic gastroparesis secondary to breast cancer.

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  • Treatment involved cisapride and chemotherapy.
  • A significant regression of both the breast tumor and the digestive symptoms, including vomiting and delayed gastric emptying, was observed.

    • Implications:

    • This case highlights that paraneoplastic gastroparesis, though uncommon, can be associated with breast cancer.
    • The condition may involve the entire gastrointestinal tract and potentially autonomic nervous system abnormalities.
    • Autoimmune mechanisms, such as auto-antibodies targeting myenteric plexuses, are hypothesized to underlie the pathology.