Anti-CV2 associated cerebellar degeneration after complete response to chemoradiation of head and neck carcinoma.
Paraneoplastic cerebellar degeneration is a rare neurological disorder that frequently precedes the detection of malignancy. Here, we report the case of a 60 year-old woman with locally advanced squamous cell carcinoma of the tongue who developed a subacute cerebellar syndrome associated with the presence of anti-CV2/CRMP5 antibodies in the cerebrospinal fluid, after achieving complete remission of the primary tumor and the involved cervical lymph nodes by chemoradiation. The patient's symptoms on presentation were dizziness and gait unsteadiness. On examination she showed dysarthria, nystagmus and limb and gait ataxia. The diagnosis of paraneoplastic cerebellar syndrome was made on the basis of the clinical findings and immunological testing that revealed the presence of anti-CV2/CRMP5 antibodies in the patient's cerebrospinal fluid. This syndrome, which is very rare in association with head and neck cancer, commonly precedes the detection of malignancy by a year or more and has been documented in only a few cases after completion of anticancer treatment.
Department of Medical Oncology, University Hospital of Heraklion, Voutes, 71110, Heraklion, Crete, Greece.
Emmanouel
E
Saloustros
Ioannis
I
Zaganas
Michail
M
Mavridis
Lambros
L
Vamvakas
Andreas
A
Plaitakis
Vassilis
V
Georgoulias
Dimitris
D
Mavroudis
D000970:Antineoplastic Agents / Q000627:therapeutic use; D001323:Autoantibodies / Q000134:cerebrospinal fluid* / Q000276:immunology; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006867:Hydrolases; D008279:Magnetic Resonance Imaging; D008869:Microtubule-Associated Proteins; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000276:immunology*; D020362:Paraneoplastic Cerebellar Degeneration / Q000134:cerebrospinal fluid / Q000276:immunology* / Q000473:pathology; D011878:Radiotherapy; D014057:Tomography, X-Ray Computed; D014062:Tongue Neoplasms / Q000150:complications* / Q000628:therapy
D000970:Antineoplastic Agents; D001323:Autoantibodies; D008869:Microtubule-Associated Proteins; D009419:Nerve Tissue Proteins; C415087:DPYSL5 protein, human; D006867:Hydrolases