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In this report, we present a challenging case involving a 60-year-old man with small cell lung carcinoma who developed symptoms of intestinal pseudo-obstruction, including abdominal distention, pain, and obstipation. Despite receiving extensive treatment with intravenous gamma globulin and glucocorticoids, the patient\u2019s symptoms did not improve, ultimately resulting in irreversible nervous system damage. Through a comprehensive literature review, we explore the underlying mechanisms of paraneoplastic CIPO and discuss its diagnostic and therapeutic approaches. 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