18F-FDG PET/CT Brain Imaging on a Patient With Paraneoplastic Opsoclonus-Myoclonus Syndrome Arising out of a Mature Cystic Teratoma

Abstract

Opsoclonus-myoclonus syndrome (OMS) is an involuntary multidirectional eye movement accompanied by myoclonic jerks and a subtype of paraneoplastic neurological syndromes. Clinical features of OMS include opsoclonus with myoclonic jerks and cerebellar ataxia. Although there have been a few studies on brain FDG PET in paraneoplastic neurological syndrome associated with some kinds of malignancies such as lung and gastric cancer, brain FDG PET of patients with OMS caused by a mature cystic teratoma has not been reported. Here, we described a case of brain FDG PET/CT studies performed in a woman with OMS provoked from a mature cystic teratoma.

Pediatric whole body MRI detects causative ovarian teratoma in opsoclonus myoclonus syndrome

“…[3,9] OMS has been suggested to be an autoimmune phenomenon that is found primarily in the pediatric population and has a slight female predominance. [9] There have been high titers of auto-antibodies found in OMS patients, though none have been specific for the syndrome itself [1]. It is postulated that these tumors associated with OMS may be producing antibodies that are etiologic to OMS.…”

“…Opsoclonus Myoclonus Syndrome (OMS, or Opsoclonus Myoclonus Ataxia) is a rare condition that presents with saccadic movements of the eyes, cerebellar ataxia, and choreiform movements of the limbs [1]. Patients may also have neurologic symptoms such as tremor, dysarthria, and high antibody titers [2].…”

“…Most commonly observed in the pediatric population, this syndrome and constellation of symptoms is often associated with neuroblastoma [3]. In rare cases, other lesions such as a benign teratoma can lead to OMS, which can be reversed with tumor removal [1,4,5]. Therefore, prompt detection and treatment of these tumors is paramount to optimal outcome.…”

Paraneoplastic opsoclonus-myoclonus syndrome as a presentation of high grade serous ovarian cancer

“…OMS has rarely been documented in relation to gynecologic neoplasms. Few case reports relate OMS to mature and immature ovarian teratomas (Fitzpatrick et al, 2008, Lou et al, 2010, Na et al, 2016), and only two prior case reports in the English literature and one in Spanish relate OMS to an epithelial ovarian carcinoma, only one of which was a case of serous cystadenocarcinoma (Rubio Nazabal et al, 2003). OMS occurs prior to the diagnosis of malignancy in the majority of cases, with occasional presentation post malignancy diagnosis (Anderson et al, 1988, Lou et al, 2010, Bataller et al, 2001, Rubio Nazabal et al, 2003).…”