Opsoclonus-Myoclonus Syndrome as a Paraneoplastic Manifestation of Renal Cell Carcinoma

Abstract

Opsoclonus is a rare but distinctive disorder of ocular motility, characterized by irregular, continual and conjugated chaotic saccades of the eyes. It is increased with eye closure and fixation, and it persists during sleep. Opsoclonus appears more commonly in children and in half of such cases in association with neuroblastoma. In adults the most frequent causes are idiopathic (50%) and paraneoplastic (20%). Among the second group, different types of tumors involving a wide variety of organs have been reported. Opsoclonus when accompanied by other symptoms of central nervous system involvement (head, appendicular myoclonus and truncal ataxia) constitutes a clinical picture, known as opsoclonus-myoclonus syndrome. We report the case of a young patient affected by renal cell carcinoma associated with opsoclonus-myoclonus syndrome which did not respond to medical therapy but dramatically improved after cancer ablation.

Paraneoplastic frontal lobe disorder and ataxia in renal cell carcinoma

“…Such immunoglobulins would not only differ in their antigen specificity but also in their affinity and cross-reactivity, which could explain a nonsignificant staining on rat brain in the case reported by De Luca et al . [1] In the present case, we were able to show binding of the pre-operative immunoglobulin fraction to large neurones in normal human brain (Figure 1). Therefore, it may be assumed that the frontal lobe syndrome in the present case resulted from disturbed function of cortical neurones due to binding of antineuronal antibodies, whereas the ataxia could be attributed to antibody binding to neurones in the brainstem and cerebellum.…”

“…Such immunoglobulins would not only differ in their antigen specificity but also in their affinity and cross‐reactivity, which could explain a nonsignificant staining on rat brain in the case reported by De Luca et al . [1]…”

Neuroblastic tumors associated with opsoclonus-myoclonus syndrome: histological, immunohistochemical and molecular features of 15 Italian cases

“…OMS may occur at any age, either as a primary disorder or in association with viral infections, degenerative or neoplastic diseases [2,24,26]. In childhood, neuroblastic tumors (NTs) are known to associate with OMS, and some cases of OMS-related renal tumors have been reported [16]. Following the first report back to 1968 [5], numerous single case reports and few series of OMS in NTs have thoroughly described these patients, providing detailed information on clinical characteristics, treatment and outcome, including neurological sequelae [1,4,11,23,25,28,29,31,35,41,42,44].…”

Adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literature

“…Rarer oncologic associations include melanoma,21 - 23 and other neoplasms of the gynecologic tract,10 , 24 - 27 as well as cancers of the urologic,15 , 28 , 29 hematologic,30 - 32 and gastrointestinal systems 15. Infections (mainly virus), idiopathic cases, and rarely toxic or metabolic disturbances account for the other half.…”