Paraneoplastic cerebellar syndrome and sensory ganglionopathy with papillary thyroid carcinoma

Gratwicke, James; Alli, Adebayo; Rollin, Matthew; Vaz, Francis; Rees, Jeremy; Vincent, Angela; Edwards, Mark J.

doi:10.1016/j.jns.2014.03.042

Cited by 11 publications

(9 citation statements)

References 6 publications

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“…One of the cases, featuring a 57-year-old female patient, was reported by Kroiss et al [7]. Gratwicke and et al reported a case with PTC, PCD, and sensory ganglionopathy [8]. In our case, the patient was diagnosed with PCD and PTC at a younger age than the previous cases in the literature.…”

Section: Discussionmentioning

confidence: 45%

“…MRI examination of PCD may be normal or reveal severe cerebellar atrophy-one study reported that 75% of patients with PCD had normal MRI findings [9]-and radiographic changes in cerebellar size are usually seen in the late stages of the disease. The patient with PTC, PCD, and sensory ganglionopathy reported in the literature had normal brain MRI findings [8], but we believe that our patient had severe bilateral cerebellar atrophy because he was admitted to hospital for ataxia in the late stage of the disease.…”

Section: Discussionmentioning

confidence: 67%

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A Rare Coexistence of Paraneoplastic Cerebellar Degeneration: Papillary Thyroid Carcinoma

Ayas

Uncu

2021

Current Oncology

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Paraneoplastic cerebellar degeneration (PCD) is a rare neuroimmunological disease that may accompany tumors. In this article, we present a patient with progressive gait difficulty who was diagnosed with PCD and, in a rare comorbidity, with papillary thyroid carcinoma (PTC) following malignancy screening. A 46-year-old male patient reported having experienced poor balance for 2 years. A neurological examination revealed nystagmus, intention tremor, and ataxia, and anti-thyroid peroxidase and anti-thyroglobulin levels were found to be elevated. A brain MRI showed significant cerebellar atrophy in the superior vermis. Malignancy screening for PCD was performed, and thyroid ultrasonography revealed a nodule in the left lobe, while PET/CT detected elevated focal F-18 fluorodeoxyglucose uptake in the thyroid. Onconeuronal antibodies (anti-Hu, anti-Yo, anti-Ri, anti-amphiphysin, anti-Tr, anti-PPCA-2, anti-Ma, anti-CV-1, and anti-ANNA-3) were negative. Pathologic examination of the thyroid revealed PTC, for which the patient was treated with 0.4 g/kg intravenous immunoglobulin and referred to the medical oncology department. This case demonstrates that clinicians must be alert to the rare comorbidity of PCD and PTC.

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Section: Discussionmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 67%

A Rare Coexistence of Paraneoplastic Cerebellar Degeneration: Papillary Thyroid Carcinoma

Ayas

Uncu

2021

Current Oncology

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“…Atrophoderma 1 27 Polymyositis 1 28 Dermatomyositis 8 [29][30][31][32][33] Perforating collagenosis 1 34 Myelopathy 1 35 Ectopic hCG secretion 2 24, this case Ectopic parathyroid hormone secretion 1 36 Panuveitis 1 37 Syndrome of inappropriate antidiuresis 1 38 Cerebellar syndrome and sensory ganglionopathy 1 39 Epidermolysis Bullosa Acquisita 1 40 Propriospinal myoclonus 1 41 Systemic lupus erythematosus 1 42 Polymyalgia rheumatica 1 43 Retinopathy 1 44 Neutrophilia & eosinophilia due to granulocyte-macrophage colony-stimulating factor 1 45 FTC Leukocytosis 1 46 Hypertrophic osteoarthropathy 1 47 ATC Ectopic hCG secretion 5 5 Hypertrophic osteoarthropathy 1 48…”

mentioning

confidence: 99%

Thyroid carcinoma producing β‐human chorionic gonadotropin shows different clinical behavior

Sui

Cui

et al. 2018

Pathology International

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Columnar cell variant of papillary thyroid carcinoma (CCV-PTC) is an unusual neoplasm, the clinical behavior of which mainly depends on the encapsulation or infiltration. Patients with extensive extrathyroidal extension usually have an aggressive biological behavior. This study confirmed that beta-human chorionic gonadotropin (β-hCG) secreting invasive CCV-PTC has good prognosis comparing with a cohort of follicular cell differentiated thyroid carcinoma. On the contrary, positive immunoreaction with β-hCG was proved in three anaplastic thyroid carcinoma patients showing aggressive clinical courses. The clinicopathologic characteristics of CCV-PTC and the paraneoplastic syndromes in follicular cell differentiated thyroid carcinoma were further summarized using literature review.

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“…Firstly, PG can be a paraneoplastic manifestation of an underlying tumor, particularly haematolymphoid malignancies (11). However, DTC is rarely related to paraneoplastic syndromes (12, 13), and in the present case PG relapsed upon reaching complete remission of PTC, thus making the relation between PG and PTC unlike in our patient.…”

Section: Discussionmentioning

confidence: 48%

Post-surgical Thyroid Bed Pyoderma Gangrenosum Mimicking Recurrent Papillary Thyroid Carcinoma

et al. 2019

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Background: Pyoderma gangrenosum (PG) is a rare inflammatory disease presenting with chronic-recurrent cutaneous ulcers histopathologically hallmarked by neutrophilic infiltrates, which may occur more frequently at sites of surgical traumas. The disease is habitually limited to the skin, but it can virtually involve any organ. Nevertheless, no prior cases of PG involving the thyroid bed have ever been reported. Case Report: A bilateral PG of the breast was diagnosed in a 51-year-old woman and treated with intravenous methylprednisolone pulse-therapy and cyclosporine, with partial improvement. During the hospitalization, cytological examination of two hypoechoic thyroid nodules by fine-needle aspiration (FNA) was consistent with thyroid carcinoma. After total thyroidectomy, histopathology confirmed a papillary thyroid cancer (PTC), and radioactive iodine ablation was performed. At 12-month ultrasonographic follow-up, two hypoechoic avascular areas localized in the empty thyroid bed raised the suspect of PTC recurrence. However, (i) undetectable levels of thyroglobulin without anti-thyroglobulin antibodies, (ii) neutrophilia and increased inflammatory marker levels, and (iii) cytological examination of FNA showing numerous neutrophils induced to suspect thyroid bed PG infiltration. An ex juvantibus approach with high-dose methylprednisolone led to dimensional reduction of the hypoechoic areas on ultrasonography, thus confirming the hypothesis of thyroid bed PG. Conclusion: This case of thyroid bed PG supports the idea that PG reflects a cutaneous phenotype encompassed in the spectrum of systemic neutrophilic diseases. Endocrinologists should be aware that thyroid bed PG involvement is an albeit rare differential diagnosis to consider in patients who had undergone thyroid surgery, especially with a history of PG.

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Paraneoplastic cerebellar syndrome and sensory ganglionopathy with papillary thyroid carcinoma

Cited by 11 publications

References 6 publications

A Rare Coexistence of Paraneoplastic Cerebellar Degeneration: Papillary Thyroid Carcinoma

A Rare Coexistence of Paraneoplastic Cerebellar Degeneration: Papillary Thyroid Carcinoma

Thyroid carcinoma producing β‐human chorionic gonadotropin shows different clinical behavior

Post-surgical Thyroid Bed Pyoderma Gangrenosum Mimicking Recurrent Papillary Thyroid Carcinoma

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