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与乳腺癌相关的副肿瘤性小脑变性:一例病例报告及文献综述。

Paraneoplastic cerebellar degeneration associated with breast cancer: A case report and review of the literature.

作者信息

Yan Lanyun, Dong Xin, Xu Huan, Huang Jingjing, Wang Wei, Huang Lin, Wan Qi, Gong Jie

机构信息

Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China.

Department of Gerontology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210011, P.R. China.

出版信息

Mol Clin Oncol. 2018 Aug;9(2):163-167. doi: 10.3892/mco.2018.1638. Epub 2018 May 25.

Abstract

Paraneoplastic cerebellar degeneration (PCD) is a rare neurological complication of cancer characterized by rapid development of cerebellar ataxia. We herein present a case of a 67-year-old female patient with PCD caused by breast cancer. The patient presented with progressively worsening cerebellar deficits that had been misdiagnosed for several months prior to the identification of the anti-Yo autoantibodies in the serum. A whole-body positron emission tomography/computed tomography scan revealed a lesion in the lower outer quadrant of the left breast with slightly increased metabolism. On mammography, a lobulated high-density mass was identified in the left breast. The patient underwent left breast lumpectomy and the histological examination confirmed the presence of an invasive ductal carcinoma. After breast surgery, he patient exhibited marked neurological improvement at the 12-month follow-up. Therefore, it is crucial that clinicians include paraneoplastic neurological syndromes in the differential diagnosis of neurological disorders. The detection of characterized onconeural antibodies in the serum or cerebrospinal fluid may provide guidance in the search for an underlying tumor.

摘要

副肿瘤性小脑变性(PCD)是一种罕见的癌症神经并发症,其特征为小脑共济失调迅速发展。我们在此报告一例由乳腺癌引起的67岁女性PCD患者。该患者出现进行性加重的小脑功能缺损,在血清中发现抗Yo自身抗体之前的几个月里一直被误诊。全身正电子发射断层扫描/计算机断层扫描显示左乳外下象限有一个代谢略有增加的病灶。乳腺钼靶检查发现左乳有一个分叶状高密度肿块。患者接受了左乳肿块切除术,组织学检查证实存在浸润性导管癌。乳房手术后,患者在12个月的随访中神经功能有明显改善。因此,临床医生在神经系统疾病的鉴别诊断中纳入副肿瘤性神经综合征至关重要。血清或脑脊液中特征性肿瘤神经抗体的检测可能为寻找潜在肿瘤提供指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e4a/6083401/788ee2c6aa93/mco-09-02-0163-g00.jpg

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