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Case Reports: Unusual presentation of more common disease/injury
Opsoclonus-myoclonus paraneoplastic syndrome in nasopharyngeal carcinoma
  1. Kirsten E Stewart1,2,
  2. Martin Zeidler3,
  3. Devraj Srinivasan4 and
  4. Justin C L Yeo2
  1. 1University of Dundee School of Medicine, Dundee, UK
  2. 2Department of Otolaryngology, NHS Fife, Kirkcaldy, UK
  3. 3Department of Neurology, NHS Fife, Kirkcaldy, UK
  4. 4Department of Oncology, NHS Lothian, Edinburgh, UK
  1. Correspondence to Kirsten E Stewart; kstewart004{at}dundee.ac.uk

Abstract

Nasopharyngeal carcinoma can present with epistaxis, cervical lymphadenopathy, audiological symptoms secondary to eustachian tube dysfunction, pain, or neurological symptoms from tumours directly invading the skull base. It is unusual for patients to present with indirect systemic manifestations. Paraneoplastic neurological syndrome can precede clinically overt malignancy by up to 5 years; therefore, a combination of thorough clinical, laboratory and radiological investigations is required to reach a diagnosis. Intravenous immunoglobulin and steroids might improve neurological symptoms initially and prevent irreversible neuronal damage, but treatment of the underlying cancer is important for long-term resolution. Our case adds to a small but growing body of literature related to anti-Ri antibodies, opsoclonus-myoclonus syndrome presentations, and is the first reported association of this combination with nasopharyngeal carcinoma.

  • Head and neck cancer
  • Pathology
  • Immunology

https://doi.org/10.1136/bcr-2022-250871

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    Footnotes

    • Contributors KES, MZ, DS and JCLY all made substantial contributions to conception and design, acquisition of data and analysis and interpretation of data. KES drafted the article and revised it critically for important intellectual content. MZ, DS, JCLY and KES all gave final approval of the version to be published. KES, MZ, DS and JCLY all agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • 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.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.