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Paraneoplastic chorea: case study with autopsy confirmation.

Ivo W Tremont-Lukats1, Gregory N Fuller, Teresa Ribalta

  • 1Neuro-Oncology Department, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.

Neuro-Oncology
|June 27, 2002
PubMed
Summary
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This case highlights a rare paraneoplastic syndrome where small-cell lung cancer caused severe chorea. Neurological symptoms, not MRI, indicated the paraneoplastic encephalitis.

Area of Science:

  • Neurology
  • Oncology
  • Immunology

Background:

  • Paraneoplastic syndromes can manifest with diverse neurological symptoms.
  • Small-cell lung cancer is a known, albeit uncommon, trigger for paraneoplastic neurological disorders.

Observation:

  • A 67-year-old man presented with progressive chorea, ataxia, and vertigo.
  • Diagnosis of small-cell lung cancer was confirmed; chemotherapy worsened chorea.
  • Anti-Hu antibodies were detected in serum and cerebrospinal fluid.

Findings:

  • Autopsy revealed widespread lymphocytic infiltrates, microglial activation, and neuronophagia.
  • Significant Purkinje cell loss was observed in the cerebellum.
  • Chorea, a rare paraneoplastic manifestation, was the predominant clinical feature.

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Implications:

  • This case underscores the importance of clinical presentation in diagnosing paraneoplastic encephalitis, even with unremarkable neuroimaging.
  • It emphasizes the diagnostic value of anti-Hu antibodies in suspected autoimmune encephalitis.
  • Highlights the critical role of recognizing rare neurological manifestations of cancer.