Case Report

A Case of Paraneoplastic Cerebellar Ataxia Secondary to Renal Cell Carcinoma

Authors: Hussam Ammar, MD, Susan H. Brown, MD, Ashok Malani, MD, FRCS, Hemant K. Sheth, MD, FACC, Eric G. Sollars, MD, Sherry X. Zhou, MD, PhD, Chakshu Gupta, MD, Snjay Mughal, MD

Abstract

A 64-year-old female patient presented with acute cerebellar ataxia. After ruling out vascular, infectious, metastatic, demyelinating, and medication etiologies, a paraneoplastic origin for her illness was determined. A renal mass was discovered and found to be renal cell carcinoma. Her symptoms resolved after a radical nephrectomy. Physicians should consider the diagnosis of paraneoplastic neurologic syndromes whenever a thorough evaluation fails to explain neurologic abnormalities.


Key Points


* Antineuronal antibodies can be helpful in making the diagnosis; however, their absence does not rule out the diagnosis of paraneoplastic neurological syndromes.


* Paraneoplastic syndromes can be a clue for diagnosing occult cancer at an early curable stage.


* The most common neoplasms reported with cerebellar ataxia are gynecologic tumors, breast and lung cancers, and lymphomas.

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References

1. Darnell RB, Posner JB. Paraneoplastic syndromes involving the nervous system. N Engl J Med 2003;349:1543–1554.
 
2. Goetz C. Goetz: Textbook of Clinical Neurology, Philadelphia, W.B. Saunders, 2003, ed 2.
 
3. Posner JB. Paraneoplastic opsoclonus/myoclonus: B cells, T cells, both, or neither? Neurology 2004;62:1466–1467.
 
4. Abeloff MD, Armitage JO, Neiderhuber JE, et al. Clinical Oncology, Edinburgh, Churchill Livingstone, 2004, ed 3.
 
5. Hagel C, Stavrou D, Hansen HC. Paraneoplastic frontal lobe disorder and ataxia in renal cell carcinoma. Neuropathol Appl Neurobiol 2005;31:97–99.