The 479th case: cognitive impairment, respiratory failure, colon mass
10.3760/cma.j.cn112138-20191115-00753
- VernacularTitle:第479例——认知功能下降，呼吸衰竭，结肠占位
- Author:
Luxi SUN
1
;
Yicheng ZHU
;
Chanyuan WU
;
Xi RUI
;
Guole LIN
;
Hailong LI
;
Dong WU
Author Information
1. 中国医学科学院 北京协和医学院 北京协和医院内科 100730
- From:
Chinese Journal of Internal Medicine
2020;59(9):741-744
- CountryChina
- Language:Chinese
-
Abstract:
A 78-year-old man was admitted to Peking Union Medical College Hospital with fever, weakness of lower extremities, less speech, loss of memory. Fever was relieved after antibiotic treatment, while cognitive impairment and disorder of consciousness progressed rapidly, followed by critical pulmonary infections, respiratory failure, and septic shock. Lab tests showed negative occult blood, normal serum CEA level and positive Anti-nuclear-antibody. PET-CT suggested that strong FDG uptake signals were seen at sigmoid, while bilateral frontal lobe, temporal lobe, parietal lobe, posterior cingulate gyrus showed lower metabolic activity. Colonoscopy biopsy revealed differentiated adenocarcinoma of sigmoid colon. Therefore, paraneoplastic syndrome of nervous system secondary to colon cancer was considered. Rapid and proper diagnosis and treatment were completed by multidisciplinary team including departments of neurology, gastroenterology, general surgery, ICU, rheumatology, clinical nutrition. The laparoscopic sigmoid colectomy was performed under general anesthesia. The patient finally presented with significant improvement of cognition and consciousness. Respiratory function was totally recovered.
