Paraneoplastic cerebellar degeneration associated with ovarian cancer

Gynecologic clear cell carcinoma and paraneoplastic cerebellar Degeneration: A literature review and case study

•Paraneoplastic cerebellar degeneration (PCD) is rare condition associated with gynecologic malignancy. •PCD presents with progressive cerebellar dysfunction in the setting of malignancy and confers a poor neurologic prognosis. •PCD associated with ovarian clear cell cancer may have more favorable neurologic outcomes versus other histologies. •The mainstay of PCD treatment is treatment of malignancy; symptom management may improve quality of life.

Anti-Yo paraneoplastic cerebellar degeneration in a patient with stage IV ovarian adenocarcinoma during bevacizumab maintenance therapy

Anti-Yo paraneoplastic cerebellar degeneration (PCD) is a rare autoimmune neurological syndrome characterised by cerebellar symptoms and frequently associated with gynaecological malignancies. While typically preceding the diagnosis of the malignancy, rarely it may present later in the disease course, heralding a recurrence prior to biochemical or radiological confirmation. Disease management is challenging and prognosis remains poor.We present the case of a woman with stage IV ovarian adenocarcinoma who developed anti-Yo PCD 16 months post malignancy diagnosis while receiving bevacizumab maintenance therapy. We review the literature and outline the difficulties in diagnosis and the frequently refractory nature of PCD to available treatments.

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

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Paraneoplastic cerebellar degeneration may precede the diagnosis of cancer.

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Early diagnosis of paraneoplastic cerebellar degeneration improve the prognosis.

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Treatment includes immunotherapy, oncological therapy and supportive therapy.

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Paraneoplastic cerebellar degeneration suspected in neurological symptoms in women.

Paraneoplastic neurologic syndromes (PNS) are a rare heterogeneous group of disorders associated with malignancy that can result in significant functional impairment. One syndrome in particular, paraneoplastic cerebellar degeneration (PCD), may be severely disabling. PCD is a rare neurological syndrome, associated with active or subclinical cancer, characterized by acute or subacute onset cerebellar ataxia due to tumor-induced autoimmunity against cerebellar antigens. Treatment of paraneoplastic syndromes is generally unsatisfactory, but early diagnosis and treatment of PCD, which includes neurological treatment, immunotherapy and oncological treatment of associated malignancy, may improve the neurological prognosis. We reported the case of a 59-year-old woman who presented PCD as the first sign of ovarian cancer. Laboratory investigations showed the presence of anti-Yo antibodies in the serum. The brain MRI revealed specific modifications for PCD. After oncological treatment, intravenous immunoglobulin therapy and corticosteroid therapy, the oncological response was satisfactory, but no improvement of the neurologic symptoms was achieved.

Paraneoplastic cerebellar degeneration heralding recurrence of fallopian tube adenocarcinoma: A case report and literature review

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Paraneoplastic cerebellar degeneration in recurrence of fallopian tube cancer.

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Describes the initial symptoms of paraneoplastic cerebellar degeneration.

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Identify a diagnosis that can lead to rapid irreversible deterioration.

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Describe management and outcomes of paraneoplastic cerebellar degeneration.

Paraneoplastic neurological syndromes associated with ovarian tumors

Introduction

Paraneoplastic neurological syndromes (PNS) are neurologic deficits triggered by an underlying remote tumor. PNS can antedate clinical manifestation of ovarian malignancy and enable its diagnosis at an early stage. Interestingly, neoplasms associated with PNS are less advanced and metastasize less commonly than those without PNS. This suggests that PNS may be associated with a naturally occurring antitumor response.

Methods

We review the literature on the diagnosis, pathogenesis and management of PNS associated with ovarian tumors: paraneoplastic cerebellar degeneration (PCD) and anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis. An approach to the diagnostic workup of underlying tumors is discussed.

Results

PCD can precede the manifestation of ovarian carcinoma. Anti-NMDAR encephalitis in young women appears often as a result of ovarian teratoma. Since ovarian tumors and nervous tissue share common antigens (e.g., cdr2, NMDAR), autoimmune etiology is a probable mechanism of these neurologic disorders. The concept of cross-presentation, however, seems insufficient to explain entirely the emergence of PNS. Early resection of ovarian tumors is a significant part of PNS management and improves the outcome.

Conclusions

The diagnosis of PNS potentially associated with ovarian tumor indicates a need for a thorough diagnostic procedure in search of the neoplasm. In some patients, explorative laparoscopy/laparotomy can be considered.