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与乳腺癌相关的副肿瘤性小脑变性:一例报告及文献综述

Paraneoplastic Cerebellar Degeneration Associated with Breast Cancer: A Case Report and a Narrative Review.

作者信息

Norrito Rosario Luca, Puleo Maria Grazia, Pintus Chiara, Basso Maria Grazia, Rizzo Giuliana, Di Chiara Tiziana, Di Raimondo Domenico, Parrinello Gaspare, Tuttolomondo Antonino

机构信息

U.O.C di Medicina Interna con Stroke Care, Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy.

出版信息

Brain Sci. 2024 Feb 14;14(2):176. doi: 10.3390/brainsci14020176.

Abstract

Paraneoplastic neurological syndromes (PNSs) are an uncommon complication of cancer, affecting nearby 1/10,000 subjects with a tumour. PNSs can involve all the central and peripheral nervous systems, the muscular system, and the neuromuscular junction, causing extremely variable symptomatology. The diagnosis of the paraneoplastic disease usually precedes the clinical manifestations of cancer, making an immediate recognition of the pathology crucial to obtain a better prognosis. PNSs are autoimmune diseases caused by the expression of common antigens by the tumour and the nervous system. Specific antibodies can help clinicians diagnose them, but unfortunately, they are not always detectable. Immunosuppressive therapy and the treatment of cancer are the cornerstones of therapy for PNSs. This paper reports a case of PNSs associated with breast tumours and focuses on the most common paraneoplastic neurological syndromes. We report a case of a young female with a clinical syndrome of the occurrence of rigidity in the right lower limb with postural instability with walking supported and diplopia, with a final diagnosis of paraneoplastic cerebellar degeneration and seronegative rigid human syndrome associated with infiltrating ductal carcinoma of the breast.

摘要

副肿瘤性神经系统综合征(PNSs)是癌症的一种罕见并发症,每10000名肿瘤患者中约有1人受其影响。PNSs可累及所有中枢和周围神经系统、肌肉系统以及神经肌肉接头,导致极其多样的症状表现。副肿瘤性疾病的诊断通常先于癌症的临床表现,因此对该病症的及时识别对于获得更好的预后至关重要。PNSs是由肿瘤和神经系统表达共同抗原引起的自身免疫性疾病。特异性抗体有助于临床医生进行诊断,但不幸的是,它们并非总能被检测到。免疫抑制治疗和癌症治疗是PNSs治疗的基石。本文报告了一例与乳腺肿瘤相关的PNSs病例,并重点介绍了最常见的副肿瘤性神经系统综合征。我们报告了一例年轻女性病例,其临床症状为右下肢僵硬、行走时姿势不稳伴支撑困难及复视,最终诊断为副肿瘤性小脑变性和与乳腺浸润性导管癌相关的血清阴性僵人综合征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7b1/10887192/72f1f230b858/brainsci-14-00176-g001.jpg

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