Vocal cord paralysis as primary and secondary results of malignancy. A prospective descriptive study

Roi Knudsen, Maria Q Gaunsbaek, Joyce H Schultz, Anna Christine Nilsson, Jonna S Madsen, Nasrin Asgari

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Resumé

Objective: Vocal cord paralysis (VCP) may be caused by a primary malignancy and associated immune cross-reactivity. We aimed to illuminate underlying causes of VCP and to assess if onconeural antibodies occur in association to VCP as an early predictor of cancer.

Methods: A prospective study was performed in patients with newly diagnosed VCP from 2014 to 2016. All patients underwent fiberoptic laryngoscopy, ultrasound of the neck and computed tomography (CT) of the neck and thorax. Patients with idiopathic VCP underwent neurological examination, positron emission tomography/CT, and serum analysis for onconeural antibodies. All patients were offered a one-year clinical follow-up.

Results: In total 53 patients fulfilled the inclusion criteria. Left VCP occurred in 37 (70%), right in 15 (28%), and bilateral in one patient (2%). The cause of VCP was cancer in 27 (51%) patients, of those 15 (56%) had VCP as the primary symptom, including all cases with laryngeal and esophageal cancer. Median time interval between VCP and cancer was 7 days (range 1-30). In 12 (23%) VCP was a secondary symptom. Lung cancer was the most common etiology, 14 of 27 (52%), 12 patients (86%) with non-small cell lung cancer. Idiopathic VCP was diagnosed in 18 (34%) patients, of those nine patients had a neurological examination and were screened for well-known onconeural antibodies, which were not detected. Reactions against Purkinje cell nuclei were seen in three patients, none showed symptoms or signs of cancer at follow-up.

Conclusions: The causes of VCP were described. VCP was frequently the primary symptom, and also occurred as a secondary symptom of cancer. Exclusion of malignancy is important in patients with VCP.

Level of Evidence: 1b.

OriginalsprogEngelsk
TidsskriftLaryngoscope Investigative Otolaryngology
Vol/bind4
Udgave nummer2
Sider (fra-til)241-245
ISSN2378-8038
DOI
StatusUdgivet - apr. 2019

Fingeraftryk

Vocal Cord Paralysis
Prospective Studies
Neoplasms
Neurologic Examination
Laryngoscopy
Laryngeal Neoplasms
Purkinje Cells
Esophageal Neoplasms

Citer dette

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title = "Vocal cord paralysis as primary and secondary results of malignancy. A prospective descriptive study",
abstract = "Objective: Vocal cord paralysis (VCP) may be caused by a primary malignancy and associated immune cross-reactivity. We aimed to illuminate underlying causes of VCP and to assess if onconeural antibodies occur in association to VCP as an early predictor of cancer.Methods: A prospective study was performed in patients with newly diagnosed VCP from 2014 to 2016. All patients underwent fiberoptic laryngoscopy, ultrasound of the neck and computed tomography (CT) of the neck and thorax. Patients with idiopathic VCP underwent neurological examination, positron emission tomography/CT, and serum analysis for onconeural antibodies. All patients were offered a one-year clinical follow-up.Results: In total 53 patients fulfilled the inclusion criteria. Left VCP occurred in 37 (70{\%}), right in 15 (28{\%}), and bilateral in one patient (2{\%}). The cause of VCP was cancer in 27 (51{\%}) patients, of those 15 (56{\%}) had VCP as the primary symptom, including all cases with laryngeal and esophageal cancer. Median time interval between VCP and cancer was 7 days (range 1-30). In 12 (23{\%}) VCP was a secondary symptom. Lung cancer was the most common etiology, 14 of 27 (52{\%}), 12 patients (86{\%}) with non-small cell lung cancer. Idiopathic VCP was diagnosed in 18 (34{\%}) patients, of those nine patients had a neurological examination and were screened for well-known onconeural antibodies, which were not detected. Reactions against Purkinje cell nuclei were seen in three patients, none showed symptoms or signs of cancer at follow-up.Conclusions: The causes of VCP were described. VCP was frequently the primary symptom, and also occurred as a secondary symptom of cancer. Exclusion of malignancy is important in patients with VCP.Level of Evidence: 1b.",
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Vocal cord paralysis as primary and secondary results of malignancy. A prospective descriptive study. / Knudsen, Roi; Gaunsbaek, Maria Q; Schultz, Joyce H; Nilsson, Anna Christine; Madsen, Jonna S; Asgari, Nasrin.

I: Laryngoscope Investigative Otolaryngology, Bind 4, Nr. 2, 04.2019, s. 241-245.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Vocal cord paralysis as primary and secondary results of malignancy. A prospective descriptive study

AU - Knudsen, Roi

AU - Gaunsbaek, Maria Q

AU - Schultz, Joyce H

AU - Nilsson, Anna Christine

AU - Madsen, Jonna S

AU - Asgari, Nasrin

PY - 2019/4

Y1 - 2019/4

N2 - Objective: Vocal cord paralysis (VCP) may be caused by a primary malignancy and associated immune cross-reactivity. We aimed to illuminate underlying causes of VCP and to assess if onconeural antibodies occur in association to VCP as an early predictor of cancer.Methods: A prospective study was performed in patients with newly diagnosed VCP from 2014 to 2016. All patients underwent fiberoptic laryngoscopy, ultrasound of the neck and computed tomography (CT) of the neck and thorax. Patients with idiopathic VCP underwent neurological examination, positron emission tomography/CT, and serum analysis for onconeural antibodies. All patients were offered a one-year clinical follow-up.Results: In total 53 patients fulfilled the inclusion criteria. Left VCP occurred in 37 (70%), right in 15 (28%), and bilateral in one patient (2%). The cause of VCP was cancer in 27 (51%) patients, of those 15 (56%) had VCP as the primary symptom, including all cases with laryngeal and esophageal cancer. Median time interval between VCP and cancer was 7 days (range 1-30). In 12 (23%) VCP was a secondary symptom. Lung cancer was the most common etiology, 14 of 27 (52%), 12 patients (86%) with non-small cell lung cancer. Idiopathic VCP was diagnosed in 18 (34%) patients, of those nine patients had a neurological examination and were screened for well-known onconeural antibodies, which were not detected. Reactions against Purkinje cell nuclei were seen in three patients, none showed symptoms or signs of cancer at follow-up.Conclusions: The causes of VCP were described. VCP was frequently the primary symptom, and also occurred as a secondary symptom of cancer. Exclusion of malignancy is important in patients with VCP.Level of Evidence: 1b.

AB - Objective: Vocal cord paralysis (VCP) may be caused by a primary malignancy and associated immune cross-reactivity. We aimed to illuminate underlying causes of VCP and to assess if onconeural antibodies occur in association to VCP as an early predictor of cancer.Methods: A prospective study was performed in patients with newly diagnosed VCP from 2014 to 2016. All patients underwent fiberoptic laryngoscopy, ultrasound of the neck and computed tomography (CT) of the neck and thorax. Patients with idiopathic VCP underwent neurological examination, positron emission tomography/CT, and serum analysis for onconeural antibodies. All patients were offered a one-year clinical follow-up.Results: In total 53 patients fulfilled the inclusion criteria. Left VCP occurred in 37 (70%), right in 15 (28%), and bilateral in one patient (2%). The cause of VCP was cancer in 27 (51%) patients, of those 15 (56%) had VCP as the primary symptom, including all cases with laryngeal and esophageal cancer. Median time interval between VCP and cancer was 7 days (range 1-30). In 12 (23%) VCP was a secondary symptom. Lung cancer was the most common etiology, 14 of 27 (52%), 12 patients (86%) with non-small cell lung cancer. Idiopathic VCP was diagnosed in 18 (34%) patients, of those nine patients had a neurological examination and were screened for well-known onconeural antibodies, which were not detected. Reactions against Purkinje cell nuclei were seen in three patients, none showed symptoms or signs of cancer at follow-up.Conclusions: The causes of VCP were described. VCP was frequently the primary symptom, and also occurred as a secondary symptom of cancer. Exclusion of malignancy is important in patients with VCP.Level of Evidence: 1b.

U2 - 10.1002/lio2.251

DO - 10.1002/lio2.251

M3 - Journal article

VL - 4

SP - 241

EP - 245

JO - Laryngoscope Investigative Otolaryngology

JF - Laryngoscope Investigative Otolaryngology

SN - 2378-8038

IS - 2

ER -