title: Gross cerebellar paraneoplastic neurological disorder in a patient with an occult breast cancer.
abstract: Paraneoplastic neurological disorders are relatively rare conditions posing both diagnostic as well as therapeutic challenges. A previously fit 66-year-old woman presented with subtle cerebellar symptoms which progressed rapidly over the course of days. Chest x-ray and routine blood tests were unremarkable. CT of the head with contrast showed no abnormality. Lumbar puncture showed no evidence of infection or oligoclonal bands. She was transferred to a neurological centre from a remote and rural setting. Subsequent MRI was reported to be normal as well. Tumour markers were negative but the paraneoplastic anti-Yo antibody was positive. A whole body CT scan revealed a spiculated left breast lesion which turned out to be malignant on fine needle aspiration. She underwent left mastectomy, had plasmapharesis and received high-dose intravenous Ig for her paraneoplastic neurological symptoms. She remained neurologically stable and underwent rehabilitation in her local hospital before getting discharged home.
authors.affiliation: Department of Medicine, Raigmore Hospital, Inverness, UK. ckpoudel@gmail.com
authors.forename: Chandra K
authors.initials: CK
authors.lastname: Poudel
authors.forename: K N
authors.initials: KN
authors.lastname: Achar
mesh_terms: D000368:Aged; D000906:Antibodies / Q000097:blood; D001943:Breast Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D009419:Nerve Tissue Proteins / Q000276:immunology; D020362:Paraneoplastic Cerebellar Degeneration / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D010956:Plasmapheresis; D011859:Radiography
chemical_list: D000906:Antibodies; C095184:CDR2 protein, human; D016756:Immunoglobulins, Intravenous; D009419:Nerve Tissue Proteins