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Subacute Paraneoplastic Cerebellar Degeneration in an Advanced Small Cell Lung Cancer Patient: Case Report and Literature Review
Pages 81-85
Maria Fernanda Evangelista Simões, Clarissa Maria de Cerqueira Mathias, Oddone Freitas Melro Braghiroli and Eldsamira da Silva Mascarenhas Schettini Sobrinho

DOI: http://dx.doi.org/10.6000/1927-7229.2015.04.02.4
Published: 13 May 2015


Abstract: Introduction: Paraneoplastic Cerebellar Degeneration (PCD) is a rare paraneoplastic syndrome, anddifficult to diagnose. PCD is associated withcertain types ofcancersuch asovarian cancer, uterus orits annexes, breast cancer, Hodgkin's lymphoma andsmall cell lung cancer (SCLC), however, this syndrome is not associated with metastatic dissemination. Here we report a caseof apatient with advanced SCLC, which develop PCD.

Case Report: Female patient, 51-year-old, largesmoker, with advancedSCLCwith involvementofabdominal lymph nodes, presented muscle weakness, without spinal cordlevel, during second-line treatment with Cisplatin and Irinotecan, even with important clinical response to chemotherapy. The patient developed nystagmusand cerebellarataxia.Cerebrospinal fluid analysisand brain magnetic resonance imagingwithoutfindings. The patient was assessed byneurologist,withclinical diagnosisof subacute PCD. Patient startedpulse therapy with methylprednisolone, withsignificant remission of neurological symptoms.

Discussion and conclusion: PCD finding, although rare, usually precedes the detection of a tumor, and it is important to start early research and treatment of cancer because of better survival and patient´s quality of life. This case differs from usual descriptions found in the literature because the patient developed PCD during good clinical response in second-line treatment. PCD evolves withprogression of the neurological conditionin weeksto monthsand thenstabilizes.The low incidencedifficult to establishtreatmentstrategies based onevidence for PCD, usually takingupaggressiveimmunotherapy, using intravenous immunoglobulin, plasmapheresis, steroids at high doses and/or immunosuppressive drugs.

Keywords: Paraneoplastic Cerebellar Degeneration, Small Cell Lung Cancer, Paraneoplastic Syndrome, Cerebellar ataxia, Nystagmus.

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