A patient with breast cancer and paraneoplastic cerebellar syndrome associated with anti-Purkinje cell antibodies: response to CMF chemotherapy.
A 41-year-old lady underwent a left mastectomy and axillary clearance in 1992, for T2N0 breast cancer. She remained well until December 1995, when she presented with a rapidly progressive cerebellar ataxia. Full investigations for metastatic disease were negative. A clinical diagnosis of paraneoplastic cerebellar degeneration was confirmed by a high titre of anti-Purkinje cell antibodies. She was treated with cyclophosphomide, methotrexate and 5-fluorouracil. The improvement in neurological symptoms was dramatic and has been maintained by further hormone manipulation (ovarian ablation). The patient now leads a normal life without medication.
Velindre NHS Trust, Cardiff, UK.
M
M
Faris
J
J
Abraham
P
P
Barrett-Lee
D000328:Adult; D000906:Antibodies / Q000032:analysis*; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000276:immunology / Q000601:surgery*; D018276:Carcinoma, Medullary / Q000276:immunology / Q000601:surgery*; D002524:Cerebellar Ataxia / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D010053:Ovary / Q000528:radiation effects; D010257:Paraneoplastic Syndromes / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D011689:Purkinje Cells / Q000276:immunology*
D000906:Antibodies; D000964:Antimetabolites, Antineoplastic; D018906:Antineoplastic Agents, Alkylating; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate