PARANEOPLASTIC DAMAGE TO THE CENTRAL AND PERIPHERAL NERVOUS SYSTEM IN BREAST CANCER: A CASE REPORT

• Main Authors: E. S. Koroleva, V. E. Goldberg, V. M. Alifirova, E. I. Simolina, N. O. Popova, V. V. Vysotskaya, Yu. V. Belevich, A. V. Goldberg, T. L. Kravchuk
• Format: Article
• Language: Russian
• Published: Tomsk National Research Medical Center of the Russian Academy of Sciences 2017-09-01
• Series: Sibirskij Onkologičeskij Žurnal
• Subjects: paraneoplastic neurological syndrome; breast cancer; neuronal antigens; onconeural antibodies; polyneuropathy; cerebellar degeneration
• Online Access: https://www.siboncoj.ru/jour/article/view/577
• ISSN: 1814-4861; 2312-3168

Paraneoplastic neurological syndrome involves the concurrent development of cancer and neurologicaldiseases. Breast cancer is the second most common cancer associated with paraneoplastic damage to the central and peripheral nervous system. Autoimmune genesis of the disease is characterized by the presence of highly specific onconeural antibodies, which selectively affect neurons in the brain cord, spinal cord and spinal ganglia, and cause the onset of neurological symptoms within 2 years before cancer is detected. Six well-characterized onconeural antibodies detected in the blood serum of breast cancer patients can be used for the laboratory diagnosis of paraneoplastic neurological syndrome. Of them, anti-Hu, anti-CV2 and anti-amphiphysin antibodies cause polyneuropathy most often. Anti-Yo antibody is usually associated with cerebellar degeneration. Multiple neuronal autoantibodies can be simultaneously detected in a patient. Removal of the tumor may lead to stabilization and even partial regression of the neurological symptoms in 70 % of patients. Therefore, the surgical treatment of cancer should consider not only the tumor extension, but also the severity and progression of neurological deficit. We present a case of paraneoplastic cerebellar degeneration and paraneoplastic polyneuropathy in a 50-year-old woman with the neurological symptoms appeared 5 months before breast infiltrating ductal carcinoma was detected. The current approaches to the diagnosis of paraneoplastic neurological syndrome, as well as feasibility of radical removal of the tumor due to progression of neurological deficit were discussed.