副肿瘤性小脑变性作为肾细胞癌的首发表现
Paraneoplastic cerebellar degeneration as initial presentation of renal cell carcinoma.
作者信息
Souza Sara M, Santos Barbara O, Sodré Isadora C A, Oliveira Ana Luiza P, Terrana Diogo, Spitz Mariana
机构信息
Neurology Service, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Blv 28 de setembro, 77 - Vila Isabel, Rio de Janeiro, 20551-030 Brazil.
出版信息
Cerebellum Ataxias. 2019 Jul 10;6:8. doi: 10.1186/s40673-019-0102-9. eCollection 2019.
BACKGROUND
Paraneoplastic cerebellar degeneration is usually associated with gynecological and breast cancer, lung cancer, and Hodgkin's lymphoma. Renal cell carcinoma has rarely been described as an underlying malignancy in these cases.
CASE PRESENTATION
We report the case of a 75 year-old woman who develop cerebellar ataxia following a respiratory viral infection. During investigation, around 1 year afterward, she noticed constitutional symptoms suggestive of malignancy. Renal carcinoma was found and the hypothesis of paraneoplastic cerebellar degeneration was considered.
CONCLUSIONS
As no specific antineuronal antibodies have been described in the setting of renal cell carcinoma, paraneoplastic cerebellar degeneration should be considered when the tumor is detected and other causes are excluded. Immunotherapy should be prescribed as soon as possible.
背景
副肿瘤性小脑变性通常与妇科和乳腺癌、肺癌以及霍奇金淋巴瘤相关。肾细胞癌在这些病例中很少被描述为潜在的恶性肿瘤。
病例报告
我们报告了一例75岁女性病例，该患者在呼吸道病毒感染后出现小脑共济失调。在大约1年后的检查过程中，她注意到有提示恶性肿瘤的全身症状。发现了肾癌，并考虑了副肿瘤性小脑变性的假说。
结论
由于在肾细胞癌病例中尚未发现特异性抗神经元抗体，因此在检测到肿瘤且排除其他病因时应考虑副肿瘤性小脑变性。应尽快开具免疫治疗药物。
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