Eaton-Lambert syndrome with small cell carcinoma of the lung

A case of Eaton-Lambert syndrome with small cell carcinoma of the lung responding favorably to chemotherapy and radiation was described. The patient, 56-year-old man, began to feel weakness of the upper limbs in 1982 (age 52). His condition deteriorated gradually, followed by weakness of the lower limbs, dysphagia and bilateral ptosis. He was admitted to our hospital in Janualy 1984. We started radiation therapy for the lung mass and his neurological findings improved slightly. In June 1984, he complained of pain in the left elbow accompanied by increased ptosis and weakness in the limbs. The biopsy of left elbow lymphnode revealed the metastasis of intermediate cell type small cell carcinoma of the lung, and the diagnosis of Eaton-Lambert syndrome was confirmed. Metastases were also found at the right parietal bone and cervical lymphnode. We started a combination chemotherapy consisting of ACNU, vincristine, methotrexate and cyclophosphamide, adding prophylactic irradiation to the cranium and metastatic regions. After treatment, the metastases disappeared completely and no abnormal findings were found except for decreased tendon reflexes of the upper limbs. Post-treatment electromyography showed marked reduction of waxing and post-tetanic facilitation. We have intermittently continued a combination chemotherapy for consolidation. The patient is living well 21 months after the distant metastases became apparent, and is showing marked improvement of Eaton-Lambert syndrome through chemotherapy and radiation. We propose that anti-neoplastic treatment is the first choice for the treatment of Eaton-Lambert syndorame associated with small cell carcinoma of long. (J.P.N.)