title: Normalization of the tumor marker CA-125 after oophorectomy in a patient with paraneoplastic cerebellar degeneration without detectable cancer.
abstract: A 61-year-old woman developed severe subacute cerebellar degeneration in association with a neuronal antinuclear autoantibody. Neurologic investigations were remarkable only for mild CSF leukocytosis. Despite no radiographic evidence of cancer, a salpingo-oophorectomy was performed on the basis of an increased gynecologic cancer marker (CA-125) and the neurologic symptoms that were strongly suggestive of paraneoplastic cerebellar degeneration. Although no tumor was detected in the surgical specimen, CA-125 levels normalized after surgery. The patient remains stable 12 months after surgery with a severe cerebellar syndrome, no evidence of cancer, and persistent circulating antineuronal autoantibodies. An elevated tumor marker in a patient with a presumed paraneoplastic neurologic disorder should suffice as evidence of an occult neoplasm, and guide definitive treatment.
authors.affiliation: Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
authors.forename: W P
authors.initials: WP
authors.lastname: Mason
authors.forename: J
authors.initials: J
authors.lastname: Dalmau
authors.forename: J P
authors.initials: JP
authors.lastname: Curtin
authors.forename: J B
authors.initials: JB
authors.lastname: Posner
mesh_terms: D001323:Autoantibodies / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood*; D002526:Cerebellar Diseases / Q000097:blood*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010052:Ovariectomy; D010053:Ovary / Q000473:pathology / Q000601:surgery; D010257:Paraneoplastic Syndromes / Q000097:blood*
chemical_list: D001323:Autoantibodies; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen