title: Paraneoplastic neurological syndromes associated with ovarian tumors.
abstract: BACKGROUND
  Paraneoplastic neurological syndromes (PNS) are neurologic deficits triggered by an underlying remote tumor. PNS can antedate clinical manifestation of ovarian malignancy and enable its diagnosis at an early stage. Interestingly, neoplasms associated with PNS are less advanced and metastasize less commonly than those without PNS. This suggests that PNS may be associated with a naturally occurring antitumor response.
  
  
  METHODS
  We review the literature on the diagnosis, pathogenesis and management of PNS associated with ovarian tumors: paraneoplastic cerebellar degeneration (PCD) and anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. An approach to the diagnostic workup of underlying tumors is discussed.
  
  
  RESULTS
  PCD can precede the manifestation of ovarian carcinoma. Anti-NMDAR encephalitis in young women appears often as a result of ovarian teratoma. Since ovarian tumors and nervous tissue share common antigens (e.g., cdr2, NMDAR), autoimmune etiology is a probable mechanism of these neurologic disorders. The concept of cross-presentation, however, seems insufficient to explain entirely the emergence of PNS. Early resection of ovarian tumors is a significant part of PNS management and improves the outcome.
  
  
  CONCLUSIONS
  The diagnosis of PNS potentially associated with ovarian tumor indicates a need for a thorough diagnostic procedure in search of the neoplasm. In some patients, explorative laparoscopy/laparotomy can be considered.
authors: Division of Gynecologic Oncology, Department of Gynecology, Obstetrics and Gynecologic Oncology, Poznan University of Medical Sciences, Polna str. 33, 60-535, Poznan, Poland, mikolaj.zaborowski@gmail.com.
authors: Mikolaj Piotr
authors: MP
authors: Zaborowski
authors: Marek
authors: M
authors: Spaczynski
authors: Ewa
authors: E
authors: Nowak-Markwitz
authors: Slawomir
authors: S
authors: Michalak
mesh_terms: D005260:Female; D006801:Humans; D015994:Incidence; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D011044:Poland / Q000453:epidemiology; D011379:Prognosis