Anti-Yo Associated Paraneoplastic Cerebellar Degeneration in Ovarian Cancer: A Rare Case Report

Abstract

Paraneoplastic cerebellar degeneration (PCD) is a rare neurological complication in cancer, characterized by the rapid development of cerebellar ataxia resulting from tumor-induced autoimmunity against cerebellar Purkinje cells. It is mostly seen in gynecological cancers, breast cancer, and small cell lung cancer. 1 Anti-Yo antibody, also known as anti-Purkinje cell cytoplasmic antibody type-1 is highly specific and the most frequently found antibody in patients with PCD. Other antibodies associated with PCD are anti-Hu, anti-Tr, anti-Ri, and anti-mGluR1. However, no antibodies are identified in nearly 40% of PCD patients. [2][3][4] PCD occurs in about 0.2% of patients with malignant tumors and is characterized by cerebellar symptoms such as ataxia, vertigo, and dysarthria. 5 Here, we present a case of anti-Yo-associated PCD in an ovarian cancer patient. CASE REPORTA 54-year-old female patient was followed up after remission of ovarian cancer and was presented to the medical oncology clinic with a 6-month history of a progressively worsening condition of tingling and unsteadiness while walking. She was diagnosed with ovarian cancer in November 2016 and was also operated on, which was followed by six cycles of carboplatin plus paclitaxel adjuvant treatment. She had no dizziness, dysphagia, diplopia, ptosis, urinary or gait incontinence, and retention. Considering a diagnosis of peripheral neuropathy due to chemotherapy in another center nearly three months ago, pregabalin was administered to the patient for these symptoms. However, it did not benefit the patient. Later, physical therapy and rehabilitation program was implemented, but even that did not benefit enough. Due to these symptoms, a brain MRI was performed and was reported as normal. She did not have any other disease or history of drug use. Also, there was no history of alcohol, smoking, and substance abuse nor any neurological disease, and malignancy was observed in her family.On physical examination, her speech was found to be dysarthric, with hypoesthesia detected in the left lower extremity. Also, ataxia was observed in her walking. However, she had no motor deficits and