Abstract
Background:
Carcinoma ovary is very rarely associated with paraneoplastic cerebellar degeneration (PCD). The first clinical manifestations of primary malignancy could be associated with paraneoplastic symptoms. The presence of specific serum onconeural antibodies (Abs) in cerebellar ataxia patients may guide clinicians to search for the primary tumor by different investigation modalities.
Case:
A 71-year female presented with symptoms of gait ataxia and urinary incontinence. There were high levels of serum anti-Yo Ab and rapid progression of symptoms with no known etiology, which led to confirmation of PCD. The whole-body positron emission tomography-computed tomography scan showed multiple peritoneal and retroperitoneal metastases with normal adnexa. The histopathology of omental nodule showed high-grade serous carcinoma suggesting an occult primary ovarian cancer with PCD as a paraneoplastic syndrome.
Results:
The patient was treated with plasmapheresis and chemotherapy. Symptoms improved transiently after plasmapheresis. But, the general condition of the patient deteriorated gradually due to catheter-induced deep venous thrombosis, paraneoplastic neurologic symptoms, and metastatic disease status.
Conclusion:
Clinicians should have knowledge of paraneoplastic symptoms for early diagnosis and appropriate treatment, which will improve the quality of life by stabilizing the neurologic symptoms.
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