16th August 2024

A 73-year-old male is seen in the neurology clinic. He has been troubled by a worsening sensory neuropathy

A 73-year-old male is seen in the neurology clinic. He has been troubled by a worsening sensory neuropathy, which he describes as electric shocks. It initially began in his left foot but has now spread up the leg and is noted in his left hand also.

His wife reports that he has also recently become extremely emotionally labile, with increasingly prominent confusion. She has additionally noticed that he sometimes has periods of unresponsiveness associated with twitching in his left hand, lasting approximately 30 seconds, following which he is very drowsy.

An autoantibody is detected in the serum.

Which is the single most likely underlying malignancy?

Select the SINGLE most appropriate option from the list below. Select ONE option only.