Paraneoplastic cerebellar degeneration with bilateral facial palsy: a rare primary presentation of breast cancer

Abstract

Paraneoplastic cerebellar degeneration is a rare dysfunction of the cerebellum associated with malignancy. Nevertheless, it is the most common paraneoplastic syndrome affecting the brain. A 50-year-old woman presented to the neurology outpatient department (OPD) with symptoms of cerebellar dysfunction since 4 months and complaints of a painless lump in the right breast and drooling from mouth since 1 month. Examination revealed classical signs of cerebellar dysfunction and a 5×5 cm lump in the right breast with a single right axillary lymph node. Serum anti-Yo antibody titre was strongly positive. The patient was referred to General Surgery OPD for opinion. After establishing the diagnosis of right breast carcinoma; she underwent a right modified radical mastectomy. She was referred to the oncologist for chemo/radiotherapy but because of poor performance status, only symptomatic treatment was pursued. Follow-up till now shows no improvement in the neurological dysfunction.

Paraneoplastic Cerebellar Degeneration

“…The paraneoplastic disorder is a rare clinical manifestation in breast cancer. [ 1 ] The nonspecific symptoms lead to delayed and/or incorrect diagnosis. We are reporting an unusual presentation of breast cancer patients, i.e., gait ataxia with dysarthria due to paraneoplastic cerebellar atrophy, without any symptoms of Parkinsonism, cognitive and behavioral changes, and sensorineural deficits.…”

“…The prognosis of the disease may be masked by the severity of PCD associated neurological morbidities. [ 1 6 ] Diagnosing the patient with such rare manifestation is critical and it needs a multidisciplinary expertized team approach.…”