Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Case Report Volume 5 Issue 10

Primary Adrenal Small Cell Carcinoma Associated with Anti-Hu Positive Limbic Encephalitis: A Case Report

Roy El Koussa1*, Matilda Abu-Saba1, Vijayta Geeta Bansal-Kapuria2, William Graft3, Vibhav Bansal4

1Mercyhealth Internal Medicine Residency, Javon Bea Hospital, Rockford, Illinois, USA
2Advocate Condell Medical Center, Libertyville, Illinois, USA
3University of Illinois College of Medicine Rockford, Rockford, Illinois, USA
4Mercyhealth Comprehensive Stroke Center, Javon Bea Hospital, Rockford, Illinois, USA

*Corresponding Author: Roy El Koussa, Mercyhealth Internal Medicine Residency, Javon Bea Hospital, Rockford, Illinois, USA.

Received: August 20,2022; Published: September 15, 2022


Background: Small cell carcinoma (SCC) is a neuroendocrine neoplasm most commonly arising from the lungs. Extrapulmonary SCC is a rare pathology that have been previously described in the literature, namely GI and GU tracts. The onconeural antibody anti-neuronal nuclear antibody type I (anti-Hu) is highly specific for SCC of the lung and, when found in the serum or CSF of a patient, warrants oncological workup to look for an occult malignancy.

Case Presentation: Here, we report the case of a 78-year-old female that presented with short-term memory loss, confusion, and altered mental status concerning for paraneoplastic neurologic syndrome. She underwent extensive diagnostic workup that revealed a positive paraneoplastic panel. Subsequent imaging studies led to the identification of a primary adrenal SCC.

Conclusion: To our knowledge, this is the first report of a primary adrenal SCC associated with anti-Hu antobodies and the development of limbic encephalitis. This case highlights the importance of a positive paraneoplastic panel in the diagnostic considerations and the potential ubiquity of the well characterized onconeural antibodies.

Keywords: Small Cell Carcinoma; Adrenal Carcinoma; Onconeural Antibodies; Anti-Hu; Limbic Encephalitis


  1. Berniker Abigail V., et al. “Extrapulmonary small cell carcinoma: imaging features with radiologic-pathologic correlation”. Radiographics : A Review Publication of the Radiological Society of North America, Inc1 (2015): 152-163.
  2. Frazier Shellaine R., et al. “The pathology of extrapulmonary small cell carcinoma”. Seminars in Oncology1 (2007): 30-38.
  3. Budhram Adrian., et al. “Diagnosing autoimmune limbic encephalitis”. CMAJ : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne19 (2019): E529-E534.
  4. Monstad Sissel Evy., et al. “Onconeural antibodies in sera from patients with various types of tumours”. Cancer Immunology, Immunotherapy : CII11 (2009): 1795-800.
  5. Graus, Francesc., et al. “A clinical approach to diagnosis of autoimmune encephalitis”. The Lancet. Neurology4 (2016): 391-404.
  6. Asztely F and E Kumlien. “The diagnosis and treatment of limbic encephalitis”. Acta Neurologica Scandinavica 6 (2012): 365-375.


Citation: Roy El Koussa., et al. “Primary Adrenal Small Cell Carcinoma Associated with Anti-Hu Positive Limbic Encephalitis: A Case Report”. Acta Scientific Neurology 5.10 (2022): 03-05.


Copyright: © 2022 Roy El Koussa, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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