Abstract
Paraneoplastic syndromes are rare first manifestations of breast cancer. In this report, we present two cases of a 58-year-old woman and a 69-year-old woman presenting with acute symptoms of paraneoplastic cerebellar degeneration (PCD) and dermatomyositis, respectively, as the first sign of breast malignancy. The patient diagnosed with PCD presented initially with ataxia, was serum anti-Yo antibody negative, and subsequently investigated to have poorly differentiated intraductal breast carcinoma. Cerebellar symptoms regressed following breast cancer surgery and chemotherapy, highlighting the better neurological prognosis associated with anti-Yo antibody negative PCD. The rarity of these presentations highlights the necessity to include an occult malignancy in the differential diagnosis when attending to such patients.
Highlights
Paraneoplastic syndromes are hypothesized to be triggered by an abnormal autoimmune system response to an underlying malignancy or by humoral factors expressed by tumour cells [1]
Several studies have documented the association between breast cancer and dermatomyositis [3], whereas the association between paraneoplastic cerebellar degeneration (PCD) and breast malignancy is less known with only a handful of cases reported
PCD is mediated by onconeural antibodies (ONAs) produced against tumour antigens
Summary
Paraneoplastic syndromes are hypothesized to be triggered by an abnormal autoimmune system response to an underlying malignancy or by humoral factors expressed by tumour cells [1]. Several studies have documented the association between breast cancer and dermatomyositis [3], whereas the association between paraneoplastic cerebellar degeneration (PCD) and breast malignancy is less known with only a handful of cases reported. Case presentation 2 A 69-year-old woman experienced 3 months of atypical chest pain, erythematous rash over her face and sunexposed areas in a classical shawl distribution (Fig. 2), arthralgia, and proximal upper extremity muscle fatigue and weakness in a symmetrical distribution. She was admitted into cardiology by the emergency department. The DM rash, reappeared 21 months post operation, and a computed tomography scan performed confirmed disease relapse with radiological findings characteristic of hepatic and pulmonary metastasis
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