Paraneoplastic Neurologic Syndrome Associated with Occult Breast Cancer: A Case Report and Review of Literature

Abstract

We report a case of occult breast cancer presenting as paraneoplastic sensory and motor neuropathy. The paraneoplastic antibody panel was negative and no other unknown identifiable antibody could be detected in the serum. Systemic treatment with four cycles of Adriamycin and cyclophosphamide was given with no significant improvement in the neurologic condition. We reviewed the literature of the last 10 years and identified 31 reported cases of paraneoplastic neurologic syndrome due to breast cancer. Paraneoplastic antibodies could be found in only 36% of patients, no identifiable antibodies in 32% of patients, and unknown antibodies in 16% of patients. The status of the paraneoplastic antibodies was not reported in 16% of patients. Only 29% of patients responded to chemotherapy with improvement in neurologic deficits. The role of systemic treatment in the progression of neurologic impairment is unclear.

Cognitive function in breast cancer patients prior to adjuvant treatment

“…Paraneoplastic syndromes, which include cognitive symptoms, have been reported in patients diagnosed with breast cancer [36,37]. Although these syndromes are relatively rare, they may partially explain the pattern of results seen in this study.…”

Paraneoplastic polymyositis presenting as a clinically occult breast cancer

“…In a review by Altaha et al, specific autoantibodies were detected in 36% of patients with breast cancer-associated paraneoplastic neurological syndromes. 11 Roja et al found that onconeural antibodies were present in only half of patients with paraneoplastic breast cancer.…”

Synchronous invasive ductal carcinoma and intravascular large B-cell lymphoma of the breast: a case report and review of the literature

“…One of the differentials entertained was a paraneoplastic syndrome, which results from tumour secretion of substances that mimic the effects of endogenous hormones and cytokines, or from the production of antitumour antibodies that cross-react with normal cells. Paraneoplastic syndromes involving the breast are rare, and it is estimated that only 36% of such patients have identifiable paraneoplastic antibodies [5]. Fever is one of the most common features, and is thought to be cytokine-mediated.…”