Paraneoplastic Neurological Syndrome as an Initial Indicator of Advanced Ovarian Cancer: A Case Report and Literature Review

Aparna K, Christopher V, Jessica P2 and Anita A

School of Medicine, Queen’s University, Kingston, Canada Department of Obstetrics and Gynecology, Queen’s University, Kingston, Canada

^*Correspondance to: Anita Agrawal 

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Abstract:

Paraneoplastic Neurological Syndromes (PNS) are a rare group of heterogenous disorders that occur in the context of malignancy. Paraneoplastic Cerebellar Degeneration (PCD) is a debilitating immune-mediated neurological syndrome characterized by the onset of acute or subacute cerebellar ataxia. There are no standard treatment guidelines for paraneoplastic syndromes, and thus, treatment is generally unsatisfactory. We present a case of a 68-year-old female with a 4-month onset of progressive neurological deficits characterized by cerebellar dysfunction. The patient also had a significant familial history of cancer and alcohol consumption. Antineuronal antibody testing showed the presence of anti-Yo antibodies, suggestive of a PNS. A CT abdomen, pelvis, and chest scan revealed a suspicious cystic ovarian epithelial neoplasm that was later confirmed as stage IIIC High-Grade Serous Ovarian Cancer (HGSOC). After intravenous immunoglobulin and corticosteroids, supportive therapy, and treatment of ovarian cancer with chemotherapy and surgical debulking, the oncological therapeutic response was excellent, indicated by the decrease of CA-125 tumor marker. Slight neurological improvement occurred for several months, followed by a period of stable symptoms and then slow neurological deterioration. This case report illustrates the unfavorable outcome of PCD despite early diagnosis and multimodal treatment. Further research is required to understand if the patient’s alcohol consumption had any role in the onset and overall course of PNS.

Keywords:

Paraneoplastic neurological syndrome (PNS); Paraneoplastic cerebellar degeneration (PCD); Ovarian cancer; Anti-Yo antibodies

Cite the Article:

Aparna K, Christopher V, Jessica P, Anita A. Paraneoplastic Neurological Syndrome as an Initial Indicator of Advanced Ovarian Cancer: A Case Report and Literature Review. Ann Clin Case Rep. 2024; 9: 2665..