Paraneoplastic cerebellar degeneration associated with cerebellar hypermetabolism: Case report.

Abstract

RATIONALE:

Paraneoplastic cerebellar degeneration (PCD) is an immune-mediated neurological deficit affecting the cerebellum. Anti-Yo antibody positive PCD is a rare occurrence most likely associated with gynecologic or breast malignancies. The identification of the underlying tumor is a diagnostic challenge in many of these patients.

PATIENT CONCERNS:

We present a 68-year-old woman with acute symptoms of PCD as a first sign of underlying occult malignancy. Further investigation revealed a positive anti-Yo antibody. Although brain magnetic resonance imaging (MRI) was unremarkable, positron emission tomography (PET)/computed tomography (CT) revealed intense hypermetabolism of cerebellum and diffused hypometabolism in the rest of brain. On 1-year follow-up, despite the primary malignancy is still unknown, her symptoms improved significantly after immunotherapy.

DIAGNOSES:

Paraneoplastic cerebellar degeneration.

INTERVENTIONS:

The patient was given IV methylprednisolone 500 mg once a day for 5 consecutive days, followed by oral prednisone 60 mg once a day for 3 months.

OUTCOMES:

The patient's symptoms were gradually improved during the hospitalization period. On one year follow up, she was able to walk independently and perform some simple tasks.

LESSONS:

Cerebellar hypermetabolism in PCD suspected patients may help confirming the diagnosis in an earlier stage and may predict a better outcome after immunotherapy.

• Authors: Ammar Taha Abdullah Abdulaziz, Xiao Qing Yu, Le Zhang, Xin Yue Jiang, Dong Zhou, Jin Mei Li
• Journal: Medicine (Medicine (Baltimore)) Vol. 97 Issue 24 Pg. e10717 (Jun 2018) ISSN: 1536-5964 [Electronic] United States
• PMID: 29901574 (Publication Type: Case Reports, Journal Article)

Chemical References

• CDR2 protein, human
• Glucocorticoids
• Nerve Tissue Proteins

Topics

• Aged
• Cerebellum (diagnostic imaging, pathology)
• Female
• Glucocorticoids (therapeutic use)
• Humans
• Immunotherapy (methods)
• Neoplasms, Unknown Primary (complications, diagnostic imaging)
• Nerve Tissue Proteins (immunology)
• Paraneoplastic Cerebellar Degeneration (diagnosis, pathology, therapy)
• Positron Emission Tomography Computed Tomography (methods)