Postoperative pulmonary embolism detected with multislice computed tomography in lung surgery for cancer

In patients with paraneoplastic SPS, surgical removal of the associating neoplasm is thought to be important in reducing neurologic symptoms. Sommer and colleagues previously reported that rats experienced spastic stiffness like human SPS with injection of purified IgG taken from a patient with paraneoplastic SPS associated with breast cancer. This suggests that paraneoplastic production of autoantibodies could be associated with paraneoplastic SPS. Clinically, Hagiwara and associates and Tanaka and coworkers reported SPS cases in which the painful stiffness was reduced by surgical resection of a thymoma. After resection, serum autoantibody titers should be reduced in such cases; however, in our patient the GAD antibody titer was once again increased 2 weeks after resection, despite a lack of symptoms. Moreover, as a result of traumatic stimulation, SPS suddenly relapsed in the clinically asymptomatic period after surgical intervention. This clinical course suggests that surgical removal of the tumor does not always mean the prevention of autoantibody productivity and is not always a curative treatment for paraneoplastic SPS, as with myasthenia gravis associated with thymoma.