INTRODUCTION: The diagnosis and treatment of the neurological paraneoplastic 
syndromes associated with lung cancer can pose a challenge both to general 
physicians and neurologists as well as pulmonologists.
CASE REPORT: A 53 year-old heavy smoker presented with a Lambert-Eaton 
myasthenic syndrome (LEMS). Bronchoscopy was normal but radiological 
examinations revealed a lymph node in site 4R. The pathological diagnosis after 
mediastinoscopy was negative. Twenty-five months later, an opacity on chest 
X-ray led to a biopsy which revealed a squamous cell carcinoma. A lobectomy was 
performed for a pT2N0M0 lesion. A significant improvement of neurological 
symptoms was seen. The myasthenic syndrome reappeared 21 months later. A local 
and general relapse was diagnosed. The patient died 10 months later despite 
chemotherapy.
CONCLUSION: LEMS occurs because of an immunological reaction against 
voltage-dependent calcium channels. LEMS is generally associated with small cell 
lung cancer occurring in three percent of cases. However, the case that we 
report shows the unusual association of LEMS with non small-cell lung cancer and 
highlights the difficulties associated in the management of this condition.