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一例卵巢癌患者中与抗Yo抗体相关的副肿瘤性小脑变性:病例报告

Paraneoplastic cerebellar degeneration associated with anti-Yo antibodies in an ovarian cancer case: A case report.

作者信息

Deac Sandra, Stana Mihaela Marioara, Havasi Andrei Dan, Cainap Calin, Popita Anca-Raluca, Bordeianu Ana Maria, Cainap Simona, Bota Madalina, Bochis Ovidiu Vasile

机构信息

Oncology Institute "Ion Chiricuta", Medical Oncology Department, Cluj Napoca, Romania.

Department of Oncology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj Napoca, Romania.

出版信息

Gynecol Oncol Rep. 2020 Dec 31;35:100695. doi: 10.1016/j.gore.2020.100695. eCollection 2021 Feb.

Abstract

Paraneoplastic neurologic syndromes (PNS) are a rare heterogeneous group of disorders associated with malignancy that can result in significant functional impairment. One syndrome in particular, paraneoplastic cerebellar degeneration (PCD), may be severely disabling. PCD is a rare neurological syndrome, associated with active or subclinical cancer, characterized by acute or subacute onset cerebellar ataxia due to tumor-induced autoimmunity against cerebellar antigens. Treatment of paraneoplastic syndromes is generally unsatisfactory, but early diagnosis and treatment of PCD, which includes neurological treatment, immunotherapy and oncological treatment of associated malignancy, may improve the neurological prognosis. We reported the case of a 59-year-old woman who presented PCD as the first sign of ovarian cancer. Laboratory investigations showed the presence of anti-Yo antibodies in the serum. The brain MRI revealed specific modifications for PCD. After oncological treatment, intravenous immunoglobulin therapy and corticosteroid therapy, the oncological response was satisfactory, but no improvement of the neurologic symptoms was achieved.

摘要

副肿瘤性神经系统综合征(PNS)是一组罕见的异质性疾病,与恶性肿瘤相关,可导致严重的功能障碍。其中一种综合征,即副肿瘤性小脑变性(PCD),可能会导致严重残疾。PCD是一种罕见的神经系统综合征,与活动性或亚临床癌症相关,其特征是由于肿瘤诱导的针对小脑抗原的自身免疫反应而导致急性或亚急性起病的小脑共济失调。副肿瘤性综合征的治疗通常不尽人意,但PCD的早期诊断和治疗,包括神经治疗、免疫治疗以及对相关恶性肿瘤的肿瘤治疗,可能会改善神经预后。我们报告了一例59岁女性,其以PCD作为卵巢癌的首发症状。实验室检查显示血清中存在抗Yo抗体。脑部MRI显示出PCD的特异性改变。经过肿瘤治疗、静脉注射免疫球蛋白治疗和皮质类固醇治疗后,肿瘤反应令人满意,但神经症状未得到改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f16/7808941/c14123f2daed/gr1.jpg

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