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Paraneoplastic phenomenon in mesothelioma
  1. Ali Bin Waqar1,
  2. Daniel Menzies2,
  3. Mared Casey3,
  4. Mark Doran4
  1. 1 Respiratory Medicine, Betsi Cadwaladr University Health Board, Bodelwyddan, UK
  2. 2 Respiratory Medicine, Glan Clwyd Hospital, Bodelwyddan, UK
  3. 3 Pathology, Glan Clwyd Hospital, Bodelwyddan, UK
  4. 4 Neurology, Glan Clwyd Hospital, Rhyl, UK
  1. Correspondence to Dr Ali Bin Waqar, Respiratory Medicine, Betsi Cadwaladr University Health Board, Bodelwyddan LL18 5UJ, UK; alibinwaqar{at}


A 71-year-old man presented with breathlessness and visual disturbance. On examination of the chest, he had signs suggestive of a right-sided pleural effusion and a neurological examination yielded conjugate vertical gaze palsy. Subsequent investigations revealed pleural thickening and mesothelioma. His anti-Ma2 antibodies were positive indicating a paraneoplastic syndrome as the cause of the vertical gaze palsy.

  • mesothelioma
  • lung cancer
  • rare lung diseases
  • asbestos induced lung disease
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  • Collaborators Ali Waqar; Daniel Menzies.

  • Contributors ABW and DM conceived the case study. MC supplied slides and provided expertise on the histopathological specimen. MD was consulted for neurology opinion and helped in exhibiting patient symptoms on the video provided.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained

  • Provenance and peer review Not commissioned; externally peer reviewed.

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