title: Anti-Ma2 paraneoplastic encephalitis associated with testicular germ cell tumor treated by carboplatin, etoposide and bleomycin.
abstract: Anti-Ma2-associated encephalitis is a paraneoplastic disorder that predominantly affects the limbic system, diencephalon and brainstem, and is usually associated with tumors of the testis. We report a 35-year-old man with a right testicular mass who presented with multiple neurological complains, and clinical, serological and radiological features compatible with anti-Ma2-associated encephalitis. After three courses of carboplatin, etoposide and bleomycin for metastatic testicular germ-cell tumor, all elevated tumor markers normalized and the retroperitoneal metastases disappeared, but the neurological disorder deteriorated. To our knowledge, this is the first case in which orchiectomy followed by carboplatin, etoposide and bleomycin for a testicular tumor with anti-Ma2 encephalitis was performed.
authors.affiliation: Department of Urology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan. kimura@gb3.so-net.ne.jp
authors.forename: Masaki
authors.initials: M
authors.lastname: Kimura
authors.forename: Mizuki
authors.initials: M
authors.lastname: Onozawa
authors.forename: Akira
authors.initials: A
authors.lastname: Fujisaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Arakawa
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Takeda
authors.forename: Joseph
authors.initials: J
authors.lastname: Dalmau
authors.forename: Kazunori
authors.initials: K
authors.lastname: Hattori
mesh_terms: D000328:Adult; D000951:Antigens, Neoplasm / Q000276:immunology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D016190:Carboplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000556:secondary / Q000628:therapy*; D009419:Nerve Tissue Proteins / Q000276:immunology*; D009919:Orchiectomy; D020361:Paraneoplastic Syndromes, Nervous System / Q000276:immunology* / Q000628:therapy*; D013736:Testicular Neoplasms / Q000473:pathology / Q000628:therapy*
chemical_list: D000951:Antigens, Neoplasm; C119249:Ma2 antigen; D009419:Nerve Tissue Proteins; D001761:Bleomycin; D005047:Etoposide; D016190:Carboplatin