A recent study has found that Lambert-Eaton Myasthenic Syndrome (LEMS), a rare disease, could also be linked to another rare condition- Merkel cell carcinoma (MCC) which is a type of skin cancer. This case study was recently published in Acta Dermato-Venereologica.
This study is one of many which explains the importance of multidisciplinary care for rare disease patients. Sometimes there is more than one thing going on.
This study was conducted by researchers from the University of Turin located in Italy. They documented the case of a 59 year old patient who was diagnosed with two different kinds of paraneoplastic syndromes which are both linked to MCC.
Paraneoplastic syndromes, such as LEMS, are a group of rare conditions which are all sparked by the body having an immune response to a type of tumor.
In the case of this patient, diagnoses were confirmed after a wide array of tests. The patient came to the emergency room after facing muscle weakness, trouble walking, double vision, and uncontrolled movements of his eyes for a two week period.
He was found to have both abnormal communication between the nerves and the muscles as well as antibodies which were self targeting. These are both consistent with LEMS presentation. For these symptoms, he was treated with fampridine (a treatment also used for those with multiple sclerosis). This therapy did improve his symptoms, but not completely.
He was tested further, which revealed lesions on the left linguine lymph nodes. He underwent a biopsy which found cancer cells that were consistent with MCC. But surprisingly, there were no skin lesions or signs of tumor, which are typical with MCC presentation. It is suspected that the lesions did originate from a tumor, but that the tumor itself had already reached remission.
After two months of radiation therapy, the man had achieved remission.
The patient had significant improvements in his walking in 6 months time. Unfortunately, he still faced issues with coordination and vision.
Due to these ongoing symptoms, he was diagnosed with paraneoplastic cerebellar degeneration (PCD) which is a condition where the immune system attacks the brain cells.
The doctors concluded that both PCD and LEMS were likely triggered when his body was fighting MCC.
In conclusion, researchers emphasize how important it is for dermatologists to be aware that paraneoplastic syndromes like LEMS can be associated with MCC.
You can read more about this study here.