Storstein A, Vedeler C, Krossnes B, Mørk S
Nevrologisk avdeling, Haukeland Sykehus, Bergen.
Tidsskr Nor Laegeforen. 1997 Aug 30;117(20):2947-8.
Paraneoplastic cerebellar degeneration is a rare remote effect of ovarian and breast carcinoma especially, and is characterised clinically by rapidly evolving pancerebellar symptoms. A woman aged 83 developed progressive vertigo, cerebellar ataxia, nystagmus and dysarthria. The cerebrospinal fluid showed slight mononuclear pleocytosis, elevated total protein and IgG concentrations, and oligoclonal bands. A magnetic resonance investigation performed within the first month of symptoms was normal. A left pelvic mass was found, possibly a carcinoma of the colon or the left ovary. Cancer antigen 125 was elevated in the serum and antibodies against Purkinje cells (anti-Yo antibodies) were demonstrated in the serum and cerebrospinal fluid. These results suggested a carcinoma of the ovary as primary site of cancer. Autopsy revealed a left ovarian adenocarcinoma and marked loss of Purkinje cells in the cerebellum. The case illustrates that anti-Yo antibodies may serve as a marker not only for paraneoplastic cerebellar degeneration, but also for the nature of the neoplasm that caused it.
副肿瘤性小脑变性是一种罕见的远隔效应，尤其多见于卵巢癌和乳腺癌，临床特征为迅速进展的全小脑症状。一名83岁女性出现进行性眩晕、小脑共济失调、眼球震颤和构音障碍。脑脊液显示轻度单核细胞增多、总蛋白和IgG浓度升高以及寡克隆带。症状出现后第一个月内进行的磁共振检查正常。发现左盆腔肿块，可能是结肠癌或左卵巢癌。血清癌抗原125升高，血清和脑脊液中检测到抗浦肯野细胞抗体（抗Yo抗体）。这些结果提示卵巢癌是癌症的原发部位。尸检发现左卵巢腺癌，小脑浦肯野细胞明显丢失。该病例表明，抗Yo抗体不仅可作为副肿瘤性小脑变性的标志物，还可用于指示引发该病的肿瘤的性质。
