title: Severe hypokinesis caused by paraneoplastic anti-Ma2 encephalitis associated with bilateral intratubular germ-cell neoplasm of the testes.
abstract: We report a 40-year-old man with severe hypokinesis as paraneoplastic manifestation of a microscopic "carcinoma in situ" of the testis. The young age of the patient, along with progressive neurologic deterioration, detection of anti-Ma2 antibodies, and ultrasound findings of bilateral microcalcifications, led to bilateral orchiectomy, revealing the tumor in both testes. After orchiectomy, neurological symptoms stabilized, but the patient eventually died of systemic complications caused by his severe neurological deficits. Anti-Ma2 paraneoplastic encephalitis should be considered in patients with severe hypokinesis, and intensive investigation and aggressive approach to treatment is encouraged to prevent progression of the neurological deficits.
authors.affiliation: Department of Neurology, The University of Tokyo, Tokyo, Japan.
authors.forename: Lumine
authors.initials: L
authors.lastname: Matsumoto
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Mana
authors.initials: M
authors.lastname: Higashihara
authors.forename: Izumi
authors.initials: I
authors.lastname: Sugimoto
authors.forename: Hisatomo
authors.initials: H
authors.lastname: Kowa
authors.forename: Junji
authors.initials: J
authors.lastname: Shibahara
authors.forename: Koichiro
authors.initials: K
authors.lastname: Nakamura
authors.forename: Jun
authors.initials: J
authors.lastname: Shimizu
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ugawa
authors.forename: Jun
authors.initials: J
authors.lastname: Goto
authors.forename: Josep
authors.initials: J
authors.lastname: Dalmau
authors.forename: Shoji
authors.initials: S
authors.lastname: Tsuji
mesh_terms: D000328:Adult; D000951:Antigens, Neoplasm / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood*; D001921:Brain / Q000276:immunology / Q000473:pathology; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000601:surgery; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D018476:Hypokinesia / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D020363:Limbic Encephalitis / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000601:surgery; D009419:Nerve Tissue Proteins / Q000276:immunology*; D009919:Orchiectomy; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D012671:Seminiferous Tubules / Q000473:pathology; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000601:surgery
chemical_list: D000951:Antigens, Neoplasm; D001323:Autoantibodies; C119249:Ma2 antigen; D009419:Nerve Tissue Proteins