Introduction/Background Paraneoplastic neurological syndromes (PNS) are rare complications of ovarian cancer. We report three (3) cases of high grade serous ovarian cancer with PNS as presenting symptom.
Methodology Three previously healthy women aged 61, 70 and 73 years respectively, were referred to Lausanne university hospital (CHUV) for investigation of recent onset neurological symptoms. Two of them suffered from static and kinetic cerebellar ataxia with the latter also experiencing dysarthria. The third patient presented rapidly progressive symmetric ascending limb weakness with areflexia and motor respiratory failure.
Brain and spinal cord MRIs did not reveal any significant pathology. The onco-neuronal serology was positive for anti-Yo antibodies in the patients with ataxia and thus enabled the diagnosis of a PNS. The patient with the paralytic syndrome was tested positive for anti-ganglioside (GD1b, GM1) antibodies and negative for onco-neuronal antibodies. The diagnosis of acute inflammatory demyelinating polyneuropathy was confirmed by elevated cerebrospinal fluid protein and by electromyoneurography. All three patients were eventually diagnosed with a FIGO III high grade serous ovarian cancer.
Results Following platinum based chemotherapy and complete surgical debulking, two of the patients recovered completely from their neurological symptoms. The third-one, who refused surgery and was only treated with platinum-based chemotherapy, experienced a transient improvement of the cerebellar ataxia and of the dysarthria. All three patients are free of oncological relapse to this day.
Conclusion Our report indicates that ovarian carcinoma can be associated with both central and peripheral PNS. Optimal oncological management of the underlying malignancy provides the best chances for complete neurological recovery. In our series the occurrence of PNS affected neither the prognosis nor the efficacy of cancer treatment.
Disclosure Nothing to disclose.
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