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Paraneoplastic cerebellitis with Kelch-like protein 11 antibodies as an initial presentation for testicular seminoma

Joshua S Mercer1, Elisha Myers2, Matthew K Labriola3

  • 1Internal Medicine-Paediatrics, Duke University Hospital, Durham, North Carolina, USA joshua.mercer10@gmail.com.

BMJ Case Reports
|August 4, 2025
PubMed

Insights

A rare paraneoplastic syndrome linked to testicular seminoma was identified in a patient with cerebellitis. Kelch-like protein 11 antibody confirmed the diagnosis, aiding treatment decisions for this neurological complication.

Area of Science:

  • Neurology
  • Oncology
  • Immunology

Background:

  • Cerebellitis can present with neurological deficits affecting ambulation and speech.
  • Paraneoplastic syndromes, often associated with malignancies, can manifest with diverse neurological symptoms.

Purpose of the Study:

  • To investigate the cause of cerebellitis in a patient with a testicular mass.
  • To identify potential paraneoplastic etiologies and novel biomarkers.

Main Methods:

  • Clinical presentation, neurological examination, MRI, CT scans, testicular ultrasound, cerebrospinal fluid (CSF) analysis, and orchiectomy.
  • CSF testing included infectious and autoimmune antibody panels, with specific testing for Kelch-like protein 11 antibody.

Main Results:

  • A pure testicular seminoma was diagnosed via orchiectomy.
  • CSF analysis revealed positivity for the Kelch-like protein 11 antibody, a novel biomarker for paraneoplastic syndrome.
  • Patient symptoms showed mild improvement after multimodal treatment.

Conclusions:

  • Kelch-like protein 11 antibody is a significant biomarker for paraneoplastic syndrome in testicular seminoma.
  • Early identification and treatment of paraneoplastic syndromes are crucial for patient outcomes.
  • This case highlights the importance of comprehensive diagnostic workup for unexplained neurological symptoms.
Keywords:
Paraneoplastic SyndromesUrological cancer

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