{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:10:04Z","timestamp":1756318204225,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,2,16]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>Lambert\u2013Eaton myasthenic syndrome (LEMS) is a rare neuromuscular junction (NMJ) disorder which is categorised as either paraneoplastic or primary autoimmune. In both forms, auto-antibodies target voltage-gated calcium channels at the presynaptic level of the NMJ. Paraneoplastic LEMS is most commonly associated with small cell lung cancer (SCLC), but it can also be caused by other malignancies. We report a rare case of paraneoplastic LEMS associated with oesophageal carcinoma. Over the course of a year, the patient presented with a range of unclear and evolving symptoms, leading to an initial diagnosis of Guillain-Barr\u00e9 syndrome and subsequently Myasthenia Gravis. The diagnosis of LEMS was confirmed serologically, after the discovery of oesophageal cancer, at a stage where treatment options were limited, leading to an unfavourable outcome. This case emphasises the importance of diagnosing LEMS before tumour detection, maintaining suspicion for LEMS in atypical presentations, and thoroughly investigating for malignancies, including extrapulmonary sites.<\/jats:p>","DOI":"10.1136\/bcr-2024-264472","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T18:40:22Z","timestamp":1741200022000},"page":"e264472","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Atypical presentation of Lambert\u2013Eaton myasthenic syndrome associated with oesophageal squamous cell carcinoma"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3774-6063","authenticated-orcid":false,"given":"Ana-Maria","family":"Bubuioc","sequence":"first","affiliation":[{"name":"Department of Neurology No. 2, Nicolae Testemi\u021banu State University of Medicine and Pharmacy, Chisinau, Moldova (the Republic of)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7137-1290","authenticated-orcid":false,"given":"Aurelia","family":"Gagiu","sequence":"additional","affiliation":[{"name":"Department of Neurology No. 2, Nicolae Testemi\u021banu State University of Medicine and Pharmacy, Chisinau, Moldova (the Republic of)"},{"name":"Diomid Gherman Institute of Neurology and Neurosurgery, Chisinau, the Republic of Moldova"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lidia","family":"Cojocaru","sequence":"additional","affiliation":[{"name":"Diomid Gherman Institute of Neurology and Neurosurgery, Chisinau, the Republic of Moldova"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vitalie","family":"Lisnic","sequence":"additional","affiliation":[{"name":"Department of Neurology No. 2, Nicolae Testemi\u021banu State University of Medicine and Pharmacy, Chisinau, Moldova (the Republic of)"},{"name":"Diomid Gherman Institute of Neurology and Neurosurgery, Chisinau, the Republic of Moldova"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"2025082710473336000_18.3.e264472.1","doi-asserted-by":"crossref","first-page":"E40","DOI":"10.1055\/s-0043-118274","article-title":"The Lambert-Eaton Myasthenic Syndrome \u2014 an Overview","volume":"02","author":"Kohler","year":"2018","journal-title":"Neurology International Open"},{"key":"2025082710473336000_18.3.e264472.2","article-title":"Lambert-eaton myasthenic syndrome; pathogenesis, diagnosis, and therapy","volume":"2011","author":"Gilhus","year":"2011","journal-title":"Autoimmune Dis"},{"key":"2025082710473336000_18.3.e264472.3","first-page":"31","article-title":"The association between Lambert-Eaton myasthenic syndrome and small cell lung carcinoma","volume":"2","author":"Briggs","year":"2013","journal-title":"Immunotargets Ther"},{"key":"2025082710473336000_18.3.e264472.4","first-page":"341","article-title":"P\/Q-type Calcium Channel Antibodies in Lambert-Eaton Myasthenic Syndrome","volume":"70","author":"Kitanosono","year":"2018","journal-title":"Brain Nerve"},{"key":"2025082710473336000_18.3.e264472.5","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(11)70245-9"},{"key":"2025082710473336000_18.3.e264472.6","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1016\/j.jocn.2012.02.039","article-title":"Lambert-Eaton myasthenic syndrome in mixed small cell carcinoma and adenocarcinoma of extrapulmonary origin","volume":"20","author":"Chang","year":"2013","journal-title":"J Clin Neurosci"},{"key":"2025082710473336000_18.3.e264472.7","unstructured":"Bubuioc AM , Kudebayeva A , Turuspekova S , et al . Lambert-Eaton Myasthenic Syndrome [\u0412\u0435\u0441\u0442\u043d\u0438\u043a \u041a\u0430\u0437\u0430\u0445\u0441\u043a\u043e\u0433\u043e \u041d\u0430\u0446\u0438\u043e\u043d\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u041c\u0435\u0434\u0438\u0446\u0438\u043d\u0441\u043a\u043e\u0433\u043e \u0423\u043d\u0438\u0432\u0435\u0440\u0441\u0438\u0442\u0435\u0442\u0430]. 2021:262\u20137."},{"key":"2025082710473336000_18.3.e264472.8","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/978-1-0716-0377-2_5","article-title":"Endoscopic Diagnosis and Treatment of Esophageal Squamous Cell Carcinoma","volume":"2129","author":"Zhang","year":"2020","journal-title":"Methods Mol Biol"},{"key":"2025082710473336000_18.3.e264472.9","doi-asserted-by":"crossref","first-page":"e1627","DOI":"10.14309\/01.ajg.0000866388.77709.b3","article-title":"S2437 A Rare Presentation of Esophageal Squamous Cell Carcinoma Presenting as a Paraneoplastic Syndrome","volume":"117","author":"Rollins","year":"2022","journal-title":"Am J Gastroenterol"},{"key":"2025082710473336000_18.3.e264472.10","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1002\/1097-0142(19910715)68:2<418::AID-CNCR2820680234>3.0.CO;2-1","article-title":"Primary Ki-1 (CD 30)-positive, large cell, anaplastic lymphoma of the esophagus","volume":"68","author":"Pearson","year":"1991","journal-title":"Cancer"},{"key":"2025082710473336000_18.3.e264472.11","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s40120-015-0034-0","article-title":"The European LEMS Registry: Baseline Demographics and Treatment Approaches","volume":"4","author":"Mantegazza","year":"2015","journal-title":"Neurol Ther"},{"key":"2025082710473336000_18.3.e264472.12","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.17.5133"},{"key":"2025082710473336000_18.3.e264472.13","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1002\/mus.24921","article-title":"Myasthenia gravis Lambert-Eaton overlap syndrome","volume":"53","author":"Oh","year":"2016","journal-title":"Muscle Nerve"},{"key":"2025082710473336000_18.3.e264472.14","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1097\/CND.0000000000000189","article-title":"A Case of Triple-Negative Myasthenia Gravis Lambert-Eaton Overlap Syndrome With Negative Agrin and LRP-4 Antibodies","volume":"21","author":"Maturana","year":"2019","journal-title":"J Clin Neuromuscul Dis"},{"key":"2025082710473336000_18.3.e264472.15","doi-asserted-by":"crossref","DOI":"10.1136\/jnnp-2018-ANZAN.97","article-title":"098\u2005A case of myasthenia gravis lambert eaton overlap syndrome (MLOS) in seronegative myasthenia gravis","volume":"89","author":"Saleem","year":"2018","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2025082710473336000_18.3.e264472.16","first-page":"731","article-title":"Myasthenia gravis Lambert-Eaton overlap syndrome: Recommended modification for the diagnostic criteria","volume":"70","author":"Oh","year":"2024","journal-title":"Muscle Nerve"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-264472","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:47:40Z","timestamp":1756316860000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-264472"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":16,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3,5]]},"published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1136\/bcr-2024-264472"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-264472","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}