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伴双侧面神经麻痹的副肿瘤性小脑变性:乳腺癌一种罕见的首发表现

Paraneoplastic cerebellar degeneration with bilateral facial palsy: a rare primary presentation of breast cancer.

作者信息

Jain Arihant, Vats Manu, Neogi Sushanto, Khwaja Geeta Anjum

机构信息

Department of General Surgery, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, Delhi, India.

Department of Neurology, G B Pant Institute of Post Graduate Medical Education and Research, New Delhi, India.

出版信息

BMJ Case Rep. 2018 Jun 21;2018:bcr-2018-224996. doi: 10.1136/bcr-2018-224996.

Abstract

Paraneoplastic cerebellar degeneration is a rare dysfunction of the cerebellum associated with malignancy. Nevertheless, it is the most common paraneoplastic syndrome affecting the brain. A 50-year-old woman presented to the neurology outpatient department (OPD) with symptoms of cerebellar dysfunction since 4 months and complaints of a painless lump in the right breast and drooling from mouth since 1 month. Examination revealed classical signs of cerebellar dysfunction and a 5×5 cm lump in the right breast with a single right axillary lymph node. Serum anti-Yo antibody titre was strongly positive. The patient was referred to General Surgery OPD for opinion. After establishing the diagnosis of right breast carcinoma; she underwent a right modified radical mastectomy. She was referred to the oncologist for chemo/radiotherapy but because of poor performance status, only symptomatic treatment was pursued. Follow-up till now shows no improvement in the neurological dysfunction.

摘要

副肿瘤性小脑变性是一种与恶性肿瘤相关的罕见小脑功能障碍。然而,它是影响大脑的最常见副肿瘤综合征。一名50岁女性因4个月来出现小脑功能障碍症状,1个月来右乳无痛性肿块及流口水症状就诊于神经内科门诊。检查发现有小脑功能障碍的典型体征,右乳有一个5×5厘米的肿块及右侧单个腋窝淋巴结。血清抗Yo抗体滴度呈强阳性。该患者被转诊至普通外科门诊征求意见。确诊为右乳腺癌后,她接受了右改良根治性乳房切除术。她被转诊至肿瘤内科进行化疗/放疗,但由于身体状况不佳,仅进行了对症治疗。至今随访显示神经功能障碍无改善。

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1
Paraneoplastic neurological complications of breast cancer.乳腺癌的副肿瘤性神经并发症
Exp Hematol Oncol. 2016 Oct 24;5:29. doi: 10.1186/s40164-016-0058-x. eCollection 2015.
3
CDR2 antigen and Yo antibodies.CDR2 抗原和 Yo 抗体。
Cancer Immunol Immunother. 2011 Feb;60(2):283-9. doi: 10.1007/s00262-010-0943-9. Epub 2010 Nov 16.
8
Progressive ataxic gait disorder.进行性共济失调步态障碍
J Clin Neurosci. 2007 Feb;14(2):153-7. doi: 10.1016/j.jocn.2005.11.037.

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