Neuromyelitis optica spectrum disorder as a paraneoplastic manifestation of lung adenocarcinoma expressing aquaporin-4

Mult Scler. 2015 May;21(6):791-4. doi: 10.1177/1352458515572241. Epub 2015 Feb 25.


Background: The observations of neuromyelitis optica spectrum disorders (NMOSD) occurring in the setting of cancer suggest that aquaporin-4 (AQP4) autoimmunity may in some cases be paraneoplastic.

Results: We describe a 72-year-old patient who developed a longitudinally extensive transverse myelitis associated with AQP4 autoantibodies in the setting of a lung adenocarcinoma recurrence. AQP4 expression was demonstrated in tumor cells. IgG in patient's cerebrospinal fluid bound to tumor cells co-localizing with AQP4 immunoreactivity.

Conclusions and relevance: This case expands the spectrum of paraneoplastic AQP4 autoimmunity highlighting the importance of considering an oncological screening in patients with late-onset NMOSD.

Keywords: Paraneoplastic; neuromyelitis optica.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma of Lung
  • Adenocarcinoma* / immunology
  • Adenocarcinoma* / metabolism
  • Adenocarcinoma* / pathology
  • Aged
  • Aquaporin 4* / immunology
  • Aquaporin 4* / metabolism
  • Autoantibodies
  • Humans
  • Lung Neoplasms* / immunology
  • Lung Neoplasms* / metabolism
  • Lung Neoplasms* / pathology
  • Male
  • Myelitis, Transverse* / immunology
  • Myelitis, Transverse* / metabolism
  • Myelitis, Transverse* / pathology
  • Neoplasm Recurrence, Local* / immunology
  • Neoplasm Recurrence, Local* / metabolism
  • Neoplasm Recurrence, Local* / pathology


  • Aquaporin 4
  • Autoantibodies