Paraneoplastic cerebellar degeneration associated with anti-Yo antibodies in an ovarian cancer case: A case report

Deac, Sandra; Stana, Mihaela Mărioara; Havași, Andrei; Căinap, Călin; Popița, Anca-Raluca; Bordeianu, Ana Maria; Căinap, Simona; Bota, Mădălina; Bochis, Ovidiu Vasile

doi:10.1016/j.gore.2020.100695

Cited by 2 publications

(6 citation statements)

References 9 publications

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“…All 20 cases where a diagnostic process was identified reported the use of multiple imaging modalities in the diagnostic workup, the most frequent pairing being an MRI with an abdominal CT. A serum or cerebral spinal fluid (CSF) paraneoplastic panel was obtained in 18 out of 20 patients [ 4 , 7 , 15 - 23 , 25 ]. Serum tumor markers, notably cancer antigen (CA) 125, were tested in half of these patients to confirm the presence of a tumor, track tumor growth, or establish remission status [ 4 , 7 , 15 - 19 , 22 - 24 ].…”

Section: Reviewmentioning

confidence: 99%

“…Fourteen articles included treatment regimens for OC patients with PCD. The most common form of treatment (60%) was combination chemotherapy regimens including carboplatin, paclitaxel, bevacizumab, doxorubicin, cisplatin, and methotrexate [ 7 , 15 - 17 , 19 , 21 - 24 ]. The most common regimen was a combination of carboplatin and paclitaxel.…”

Section: Reviewmentioning

confidence: 99%

“…Treatment involved treating the underlying malignancy and then addressing PCD via immunomodulating therapy. Intravenous immunoglobulin (IVIg) (40%) [ 7 , 17 , 19 , 21 , 24 , 25 ] and corticosteroids (35%) [ 17 , 19 , 21 , 25 ] were the most common treatments used for managing PCD symptoms. Other immunosuppressants utilized for managing PCD symptoms were tacrolimus (15%) [ 16 , 21 ] and plasmapheresis (15%) [ 21 ].…”

Section: Reviewmentioning

confidence: 99%

“…In the group of patients that did achieve symptomatic recovery, we found that dysphagia and simple speech progression were restored first, followed by lower limb motor strength, upper limb motor strength, and eventually gait restoration [ 7 , 17 , 18 , 20 , 22 ]. Neurological impairment can continue to worsen and eventually be the cause of death despite treating PCD [ 19 ].…”

Section: Reviewmentioning

confidence: 99%

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An Etiological Investigation of Paraneoplastic Cerebellar Degeneration in Ovarian Cancer Patients: A Systematic Review

Fidahussain¹,

Ali²,

Paracha³

et al. 2022

Cureus

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Paraneoplastic syndromes (PNS) are uncommon, distinct clinical complications of a primary tumor. Paraneoplastic cerebellar degeneration (PCD) is a PNS that is described as an autoimmune response targeting Purkinje cells in the cerebellum. Ovarian cancer (OC) is one of the most prevalent causes of cancer-related deaths in women. Anti-Yo is the most common onconeural antibody produced in the PCD immune response and is most typically found in ovarian and breast cancer patients. While the current literature highlights the predisposing genetic factors, diagnostic workflows, and treatment options, the pathophysiology of PCD, among other considerations, remains largely unestablished. This review aimed to systematically observe procedural solutions to facilitate an early diagnosis and improve the prognosis of patients with OC-associated PCD. To that end, we examined literature published from 01/01/2015-11/10/2022 indexed in PubMed by using the keywords "paraneoplastic, cerebellar degeneration" combined with "ovarian cancer." Inclusion criteria were met if PCD and OC diagnoses were made and if studies provided adequate patient information. After screening and assessing records for eligibility using the inclusion and exclusion criteria, 18 articles involving 102 patients were included. The typical patient observed in this sample was diagnosed with International Federation of Gynecology and Obstetrics (FIGO) Stage III, high-grade serous carcinoma. The diagnostic workup typically included a clinical evaluation for dysarthria (50%), ataxia (60%), and gait abnormalities (50%), along with multiple imaging modalities and serological findings (90%). Genetic screening for human leukocyte antigen (HLA) haplotype susceptibility for PCD and immune tolerance modulators regulation may also be recommended prior to starting treatment. Findings support the use of corticosteroids (35%) and intravenous immunoglobulin (IVIg) (40%) as viable treatment options for managing PCD in conjunction with systemic therapy for the primary malignancy. A diagnosis of PCD should be considered if a patient has had a malignancy in the past five years with the presence of explicit cerebellar symptoms. This clinical diagnosis can be further supplemented by serologic and radiologic findings. Recognizing PCD symptoms and scheduling genetic and proteomic testing may help with early diagnosis and better prognosis.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

See 2 more Smart Citations

An Etiological Investigation of Paraneoplastic Cerebellar Degeneration in Ovarian Cancer Patients: A Systematic Review

Fidahussain¹,

Ali²,

Paracha³

et al. 2022

Cureus

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“…PNS can affect any part of the central and peripheral nervous system[ 4 - 6 ]. Most paraneoplastic syndromes are caused by autoimmune cross-reactions between tumor antigens and proteins expressed in the nervous system[ 7 - 11 ]. PNS is rare, affecting less than 0.6-1/10000 patients with cancer[ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Paraneoplastic neurological syndrome caused by cystitis glandularis: A case report and literature review

Zhao¹,

Liu²

2022

World J Clin Cases

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BACKGROUND Paraneoplastic neurological syndrome (PNS) is an unusual event. PNS caused by cystitis glandularis (CG) or a bladder tumor is extremely rare; hence, missed diagnosis or misdiagnosis can easily occur. To date, approximately 21 cases have been reported in PubMed. CASE SUMMARY We report a case of PNS caused by CG and describe the clinical and imaging features. The main clinical feature was advanced cognitive impairment, and early clinical features were memory impairment, decreased computational ability, and abnormal behavior. Later clinical features were dementia, vomiting, inability to eat and walk, urinary incontinence, and hematuria. Imaging features on cranial magnetic resonance imaging were diffuse white matter lesions. Paraneoplastic tumor markers were normal. A total abdominal computed tomography scan showed multiple thickened areas on the bladder wall with local prominence. Cystoscopy revealed a volcanic protuberance on the posterior wall of the bladder with a diameter of 6 cm and no pedicle. The postoperative pathological diagnosis was CG. The patient recovered well following resection of CG. PNS cases caused by previous bladder tumors can be retrieved from PubMed to describe the clinical signs and prognosis of PNS. CONCLUSION The main clinical feature of PNS caused by CG was dementia, and the imaging features were diffuse cerebral white matter lesions. Resection of CG lesions is the fundamental treatment for PNS induced by CG. This case highlights the importance of etiological treatment.

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Paraneoplastic cerebellar degeneration associated with anti-Yo antibodies in an ovarian cancer case: A case report

Cited by 2 publications

References 9 publications

An Etiological Investigation of Paraneoplastic Cerebellar Degeneration in Ovarian Cancer Patients: A Systematic Review

An Etiological Investigation of Paraneoplastic Cerebellar Degeneration in Ovarian Cancer Patients: A Systematic Review

Paraneoplastic neurological syndrome caused by cystitis glandularis: A case report and literature review

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