Clin Endosc.  2023 Mar;56(2):245-251. 10.5946/ce.2021.076.

Colorectal carcinoma and chronic inflammatory demyelinating polyneuropathy: is there a possible paraneoplastic association?

• Malik A
• Inayat F
• Goraya MHN
• Nawaz G
• Mehran A
• Aziz A
• Saleem S

• KMID: 2540743
• DOI: http://doi.org/10.5946/ce.2021.076

Abstract

A plethora of paraneoplastic syndromes have been reported as remote effects of colorectal carcinoma (CRC). However, there is a dearth of data pertaining to the association of this cancer with demyelinating neuropathies. Herein, we describe the case of a young woman diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP). Treatment with intravenous immunoglobulins and prednisone did not improve her condition, and her neurological symptoms worsened. Subsequently, she was readmitted with exertional dyspnea, lightheadedness, malaise, and black stools. Colonoscopy revealed a necrotic mass in the ascending colon, which directly invaded the second part of the duodenum. Pathologic results confirmed the diagnosis of locally advanced CRC. Upon surgical resection of the cancer, her CIDP showed dramatic resolution without any additional therapy. Patients with CRC may develop CIDP as a type of paraneoplastic syndrome. Clinicians should remain cognizant of this potential association, as it is of paramount importance for the necessary holistic clinical management.

Keyword

Chronic inflammatory demyelinating polyneuropathy; Colorectal neoplasms; Paraneoplastic syndromes

Figure

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  Fig. 1. Endoscopic evaluation. (A) Upper endoscopy showing a mass in the second part of the duodenum. (B) Colonoscopy showing a large, necrotic mass in the ascending colon.

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  Fig. 2. Abdominopelvic contrast-enhanced computed tomography findings. (A) Coronal reformatted section showing a large circumferential heterogeneously enhancing necrotic mass involving the ascending colon up to the hepatic flexure, causing significant luminal narrowing. The superior component of the mass is infiltrating into the descending portion of the duodenum. (B) Axial section showing abnormal wall thickening of the large bowel, more pronounced on the lateral side of the ascending colon, with significant fat stranding (black arrow). Dilated small bowel loop along with fecal loading due to the obstruction caused by the tumor mass (white arrow).

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  Fig. 3. Flow diagram representing the search methodology for data synthesis regarding the association of colorectal carcinoma with chronic inflammatory demyelinating polyneuropathy.

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