Paraneoplastic Cerebellar Ataxia due to Burnt-Out Testicular Germ Cell Tumour?

Paraneoplastic neurological syndrome due to burned-out testicular tumor showing hot cross-bun sign

“…The clinical features in our patient are very similar to those reported previously (5).But in the previous report, there were different symptoms such as inability to abduct both eyes, decline of cognitive functions with imaging abnormalities reminiscent of limbic encephalitis at 4 years of disease. In our case, it is presumed that antigens of germ cell tumor were removed by laparotomy and then, production of antibodies was decreased and led to the improvement of neurological disabilities.…”

“…To our knowledge, there has been only one case with PNS and burned-out testicular tumor (5). The present patient and the one in the previous report displayed burned-out testicular tumor combined with cerebellar ataxia and hearing loss without evidence of known onconeural antibodies and therefore suggested PNS in the cerebellum and auditory nerve which was associated with burnedout testicular tumor.…”

“…To our knowledge, only one case has been described with possible PCD due to burned-out testicular tumor (5). Here, we report a patient with cerebellar ataxia who was diagnosed as PNS due to burned-out testicular tumor.…”

Paraneoplastic cerebellar degeneration associated with thymic germinoma

“…PCD and germinoma were previously reported in three patients and the tumor antedated the diagnosis of PCD in all of them [3,9,10]. In another patient, the presence of a subacute severe cerebellar syndrome preceded the diagnosis of a burn-out testicular germinoma for 4 years [11]. Benign teratomas, almost always of ovarian origin may cause encephalitis, associated with antibodies against the NR1 subunit of the glutamate receptor NMDA [12] and exceptionally opsoclonus-myoclonus syndrome without any associated antibody [13].…”

A unique case of pronounced neurologic deficit from paraneoplastic syndrome that precedes appearance of mediastinal germinoma by two years

“…Further, the association between germinomas and PCD has only rarely been reported, and in the cases reported, antibodies were either not evaluated or found to be negative. [12][13][14][15][16] However, it should be noted that in our patient, sensorimotor and cranial nerve symptomatology suggests that the neurologic syndrome may have been distinct from an overlap syndrome (with brainstem involvement) in addition to PCD.…”