[RAPIDLY PROGRESSING PARAPARESIS AND LOSS OF SENSATION BELOW T10 DURING NEOADJUVANT CHEMOTHERAPY FOR BREAST CANCER]

Area of Science:

• Oncology
• Neurology

Background:

• A 35-year-old woman with stage 2, HER2-negative invasive ductal carcinoma and high ki-67 (60%) received neoadjuvant chemotherapy.
• Following chemotherapy, she developed rapid progressive neurological deficits including weakness and sensory loss in both legs.

Purpose of the Study:

• To report a case of Guillain-Barre syndrome (GBS) mimicking leptomeningeal carcinomatosis in a breast cancer patient.
• To emphasize the importance of considering non-cancerous etiologies in cancer patients presenting with new neurological symptoms.

Main Methods:

• Clinical presentation, MRI findings, lumbar puncture, and electromyography (EMG) were used for diagnosis.
• Treatment involved high-dose dexamethasone, initial radiotherapy, followed by intravenous immunoglobulins (IVIG) upon GBS diagnosis.

Main Results:

• Initial MRI showed diffuse leptomeningeal enhancement, suggestive of metastasis.
• Lumbar puncture revealed elevated protein, and EMG demonstrated demyelinating injury consistent with GBS.
• The patient showed significant neurological recovery after IVIG treatment.

Conclusions:

• New neurological symptoms in cancer patients can be misattributed to disease progression.
• A broad differential diagnosis, including GBS, is crucial for accurate and timely management.
• Early diagnosis and appropriate treatment of GBS led to near-complete resolution of neurological deficits.