This case describes a 69-year-old woman, who presented with rapidly progressive cerebellar symptoms and unintentional weight loss. Full neurological assessment excluded space-occupying lesions, vascular accidents and infection. Surprisingly, a chest, abdomen and pelvis CT showed a left hemipelvis mass, which was subsequently biopsied. A high-grade serous carcinoma of tubo-ovarian origin was found, diagnosing paraneoplastic cerebellar degeneration (PCD) secondary to this. The exact mechanism is not known, but is thought to be immune-mediated. In cases of PCD, after cancer treatment, the neurological disability stabilises to a severe level and will unfortunately be lifelong. Our patient continues to make great progress with intensive rehabilitation for her ongoing balance issues. Early recognition of PCD can lead to a prompt diagnosis of the underlying malignancy and hence subsequent management. This can at least limit the extent of the neurological disability of the disease and increase the survival rate from cancer.
- obstetrics, gynaecology and fertility
- brain stem / cerebellum
- cancer - see oncology
- gynecological cancer
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Contributors EB: consented the patient, contributed to conception and design, contributed to interpretation, drafted the manuscript, and critically revised the manuscript. JAT: critically revised the manuscript and obtained and analysed the pathology images. KRC: contributed to the conception and design, interpretation and critically revised the manuscript. JL: contributed to conception and design, critically revised the manuscript and gave overall supervision to the project. All authors gave final approval.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Patient consent for publication Obtained.
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