title: Long extensive transverse myelitis associated with aquaporin-4 antibody and breast cancer: favorable response to cancer treatment.
abstract: BACKGROUND
  Long extensive transverse myelitis (LETM) seldom develops in patients with breast cancer who are aquaporin-4 antibody (Aqp-4 Ab)-positive. Whether this association is coincidental is not well understood.
  
  
  RESULTS
  A 62-year-old woman presented with  treatment-resistant LETM and Aqp-4 Ab. Two months later, a stage 3 invasive ductal carcinoma was detected in her right breast. Following tumor resection and chemotherapy, her neurologic symptoms and magnetic resonance imaging findings significantly improved and serum Aqp-4 Ab disappeared.  The breast tumor samples of this patient and neurologically normal patients showed inflammatory infiltrates and Aqp-4 expressing cells.
  
  
  CONCLUSIONS
  The temporal association between tumor treatment, amelioration of clinical findings, and seroreversion suggest  that coexistence of cancer and LETM is not coincidental. Cancer screening should be considered at least in treatment-resistant LETM cases.
authors.affiliation: Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Haydar
authors.initials: H
authors.lastname: Armağan
authors.forename: Erdem
authors.initials: E
authors.lastname: Tüzün
authors.forename: Sema
authors.initials: S
authors.lastname: Içöz
authors.forename: Omer
authors.initials: O
authors.lastname: Birişik
authors.forename: Canan
authors.initials: C
authors.lastname: Ulusoy
authors.forename: Gökhan
authors.initials: G
authors.lastname: Demir
authors.forename: Ayşe
authors.initials: A
authors.lastname: Altıntaş
authors.forename: Gülşen
authors.initials: G
authors.lastname: Akman-Demir
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D051401:Aquaporin 4 / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D001324:Autoantigens / Q000276:immunology; D001943:Breast Neoplasms / Q000150:complications* / Q000276:immunology / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000150:complications* / Q000276:immunology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D009188:Myelitis, Transverse / Q000150:complications* / Q000276:immunology; D010257:Paraneoplastic Syndromes / Q000209:etiology* / Q000276:immunology
chemical_list: C496030:AQP4 protein, human; D000970:Antineoplastic Agents; D051401:Aquaporin 4; D001323:Autoantibodies; D001324:Autoantigens