Breast cancer-related paraneoplastic neurologic disease

Murphy, Brittany L.; Zalewski, Nicholas L.; Degnim, Amy C.; McKeon, Andrew; Flanagan, Eoin P.; Pittock, Sean J.; Habermann, Elizabeth B.

doi:10.1007/s10549-017-4566-0

Cited by 22 publications

(18 citation statements)

References 33 publications

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“…PNSs are generally associated with certain types of tumors, such as small cell lung cancer, thymoma, breast cancer, ovarian cancer, Hodgkin and non-Hodgkin lymphoma, testicular cancer, and neuroblastoma [7]. Breast cancer-related PNSs are very rare, in fact, Murphy et al reported that only 56 cases had occurred in their institution (Mayo Clinic, USA) in the past 20 years [8]. The average age of patients was 50 years and most patients had hormone receptor (HR) positive and Her2 negative, stage II disease [8].…”

Section: Discussionmentioning

confidence: 99%

“…Breast cancer-related PNSs are very rare, in fact, Murphy et al reported that only 56 cases had occurred in their institution (Mayo Clinic, USA) in the past 20 years [8]. The average age of patients was 50 years and most patients had hormone receptor (HR) positive and Her2 negative, stage II disease [8]. PNSs include paraneoplastic cerebellar degeneration (PCD), opsoclonus myoclonus syndrome (OMS), stiff person syndrome, paraneoplastic neuropathy, and paraneoplastic encephalomyelitis.…”

Section: Discussionmentioning

confidence: 99%

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Anti-Ri-associated paraneoplastic ophthalmoplegia-ataxia syndrome in a woman with breast cancer: a case report and review of the literature

et al. 2020

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Background: Breast cancer is the most common cancer in women. However, in the management of breast cancer, paraneoplastic neurological syndromes represent a diagnostic and therapeutic challenge. The diagnosis of paraneoplastic neurological syndromes is difficult due to the heterogeneity of symptoms, the timing of presentation, and the absence of antibodies, and it generally occurs before the diagnosis of breast cancer in 80% of patients who develop paraneoplastic neurological syndromes. We describe a 72-year-old woman with subacute ophthalmoplegia-ataxia syndrome who was subsequently diagnosed as having breast cancer and anti-Ri antibodies. Case presentation: A 72-year-old post-menopausal Caucasian woman, with a positive medical history for diabetes mellitus and hypertension, presented with a 3-month onset of blurred vision, diplopia, and progressive gait disturbance. Serological tests were positive for well-characterized onconeural antibodies (anti-Ri). A whole-body computed tomography scan revealed a nodular opacity under her left nipple and axillary adenopathy. A biopsy of her left breast was performed, and histological examination showed ductal carcinoma. She underwent a superoexternal quadrantectomy with left axillary dissection. The final diagnosis showed infiltrating ductal carcinoma of the breast (T1c N1 M0, stage IIA) associated with paraneoplastic ophthalmoplegia-ataxia syndrome. At a 6-month follow-up, she showed no clinical or instrumental evidence of neoplastic recurrence with partial clinical improvement of neurological symptoms, such as ataxia and diplopia. Conclusion: The diagnosis of paraneoplastic neurological syndromes is often late, as in this patient, but treatment at an early stage may provide a good prognosis. Furthermore, this is one of several cases of an anti-Ri paraneoplastic neurological syndrome not associated with myoclonus, which reinforces the belief that opsoclonus myoclonus syndrome is not pathognomonic of the associated anti-Ri paraneoplastic neurological syndromes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Anti-Ri-associated paraneoplastic ophthalmoplegia-ataxia syndrome in a woman with breast cancer: a case report and review of the literature

et al. 2020

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“…Tumor cells are transported to lymph nodes or lymphatic organs to present antigen to CD4 + T, CD8 + T and B cells after apoptosis. Immune response secondary to enlargement of lymph nodes and organs with increased B and T lymphocytes occurs [ [15] , [16] , [17] , [18] , [19] ]. However B and T lymphocyte responses do not always produce an anti-tumoral response and sometimes are thought to cause autoantigen formation and autoimmunity triggering and/or paraneoplastic syndromes.…”

Section: Discussionmentioning

confidence: 99%

Determination of Paraneoplastic neuropathy in newly diagnosed breast tumor patients

Sayman¹,

Hülya²,

Tüzün

et al. 2020

eNeurologicalSci

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Objective The presence of paraneoplastic neuropathy in newly diagnosed breast tumor patients will be investigated. Aim of study is conduce of early diagnosis of the disease and new biomarkers responsible for the pathogenesis to be identify. Materials and Methods Thirty-two patients admitted to the Oncology outpatient clinic with newly diagnosed breast cancer were included in the study. After the neurological examination of the patients, Lanss neuropathic pain scale and blood tests were performed. Before chemotherapy all patients underwent electromyography (EMG). Two tubes of 5 cc of venous blood were obtained by screening onconeuronal antibodies. Results Patients included in the study; 1 (3.1%) grade 1, 14 (43.8%) grade 2, 17 (53.1%) grade 3 invasive breast cancer was diagnosed. Perineural invasion was detected in 5 (15.6%) patients. Progesterone receptor positivity was found in 26 (81.2%) patients and estrogen receptor positivity was found in 27 (84.4%) patients. In 7 (21.9%) patients, CERBB2 was positive for Ki 67 in 25 (78.1%) patients. Neuropathic findings were present in 6 (18.8%) patients. Sensory neuropathy was detected by electrophsiologic tests in only 2 (6.2%) patients. A total of 12 (37.5%) patients had onconeuroneal antibody positivity. Antibody positivity was significantly higher in patients with high grade tumor ( p = 0.008). Conclusion Paraneoplastic neuropathies can be confused with neuropathies due to non-cancerous causes both clinically and electrophysiologically. When approaching paraneoplastic neuropathies, pathological findings should be carefully reviewed and evaluated with other findigs. It should be remembered that an underlying breast tumor may be present in women with cancer-related neuropathic complaints.

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“…PND is a rare disease. From all cases of PND and breast cancer, 3.6% are related to PLE . From all cases with PLE, breast cancer is the second most common tumor, representing 4.5% to 8% of all cases .…”

Section: Discussionmentioning

confidence: 99%

Paraneoplastic syndrome in neuroendocrine breast cancer: A case report

et al. 2019

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Background Paraneoplastic syndromes are rare manifestations of underlying malignancies, most commonly small cell lung cancer and invasive ductal carcinoma of the breast. Case We present a case of anti‐AMPA receptor paraneoplastic limbic encephalitis, a specific paraneoplastic syndrome, in a woman with neuroendocrine breast cancer. Her condition improved with surgical resection and chemotherapy. Conclusion This is the first known case of anti‐AMPA receptor paraneoplastic limbic encephalitis in a patient with primary neuroendocrine breast cancer.

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Breast cancer-related paraneoplastic neurologic disease

Cited by 22 publications

References 33 publications

Anti-Ri-associated paraneoplastic ophthalmoplegia-ataxia syndrome in a woman with breast cancer: a case report and review of the literature

Anti-Ri-associated paraneoplastic ophthalmoplegia-ataxia syndrome in a woman with breast cancer: a case report and review of the literature

Determination of Paraneoplastic neuropathy in newly diagnosed breast tumor patients

Paraneoplastic syndrome in neuroendocrine breast cancer: A case report

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