title: Case report: Paraneoplastic neurologic syndrome associated with squamous cell carcinoma of the tonsil.
abstract: Paraneoplastic syndromes include a variety of disorders that affect the neurologic, endocrine, mucocutaneous, hematologic, and other systems as a result of neoplastic disease. Although their presentations vary, syndromes occur when tumor antigens exhibit cross-reactivity to similar antigens expressed by these systems. The antigens in the nervous system are called "onconeural" antigens. Although many disorders are associated with a comparatively high incidence of paraneoplastic neurologic syndromes, only a few cases have been associated with squamous cell carcinoma (SCC) of the tonsil. We report the case of a 69-year-old man who initially presented with weakness and spastic gait. He was subsequently found to have a characteristic paraneoplastic tractopathy on thoracic magnetic resonance imaging. The subsequent workup and operative intervention identified a T2N0M0 SCC of the tonsil. Following resection, the patient's overall symptoms were significantly alleviated, and his gait improved. A thorough literature search yielded no other report of a tonsillar SCC with associated paraneoplastic thoracic spine tractopathy.
authors.affiliation: Department of Otorhinolaryngology, Mayo Clinic, 200 First St., SW, Gonda Bldg., 12th Floor, Rochester, MN 55905, USA. janus.jeffrey@mayo.edu.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Janus
authors.forename: Sivakumar
authors.initials: S
authors.lastname: Chinnadurai
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Moore
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006801:Humans; D008297:Male; D018908:Muscle Weakness / Q000209:etiology; D020361:Paraneoplastic Syndromes, Nervous System / Q000150:complications* / Q000175:diagnosis; D014067:Tonsillar Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery