Paraneoplastic neurological syndrome: patient with anti-Yo antibody and breast cancer: a case report

Abstract

Presented here is the case of a paraneoplastic cerebral degeneration (PCD) in a female patient with breast cancer and the indication of anti-Yo antibodies in the cerebrospinal fluid (CSF) and serum. The patient's primary indications were dizziness and a severe gait ataxia. The indication of anti-Yo antibodies led to the conclusion of the existence of a paraneoplastic cerebral degeneration. The antibodies in question are anti-Purkinje-cell autoantibodies acting against the antigens common to tumor and Purkinje cells which occur in association with a certain percentage of breast or ovarian cancers. The diagnosis of the primary tumor, that is clinically undetectable with conventional imaging processes, is performed with the aid of positron emission tomography (PET) to detect the presence of axillary lymph node metastases. The micro-invasive mammary carcinoma was able to be localized with the aid of MR mammography and, after MR mammography marking, was removed. The patient subsequently received adjuvant treatment with epirubicine and cyclophosphamide. This treatment failed to influence the paraneoplastic neurological symptoms.

CSF proteome: a protein repository for potential biomarker identification

“…Identification of autoantibodies, anti-Yo and anti-Hu, in the CSF are diagnostic for certain breast, lung and ovarian tumors [51,52]. Detection of these antibodies in the CSF, in the absence of overt malignant disease, indicates a high likelihood of an occult tumor.…”

Paraneoplastic Neurological Syndromes and the Role of PET Imaging

“…Presence of the anti-Yo (Purkinje cell cytoplasmic antibody type 1, PCA-1) antibody in the serum is associated with breast or ovarian cancers and manifested as paraneoplastic cerebellar degeneration [13,14]. The paraneoplastic antibody PCA-2 (Purkinje cell cytoplasmic antibody type 2) is associated with brainstem or limbic encephalitis, paraneoplastic cerebellar degeneration, and LEMS, in patients with SCLC [15].…”

Paraneoplastic cerebellar degeneration associated with serous adenocarcinoma of the ovary

“…Though there have been attempts to treat the neurological symptoms using chemotherapy, immunosuppression and/or immunoglobulins, no significant improvement in patient's clinical symptoms were yielded 17. The main determinant of overall survival is the surgical resection of the neoplasm in conjunction with chemotherapy.…”