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Paraneoplastic cerebellar degeneration and dermatomyositis as first manifestations of underlying breast malignancy: a report of two cases and a brief review of the subject.

Ng YR, Ho CD, Ng WL, Tan SM - Surg Case Rep (2015)

Bottom Line: 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.The rarity of these presentations highlights the necessity to include an occult malignancy in the differential diagnosis when attending to such patients.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Changi General Hospital, 2 Simei Street, Singapore, 529 889 Singapore.

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.

No MeSH data available.


Related in: MedlinePlus

Erythematous rash typical of dermatomyositis on the patient’s neck and shoulders in a classical shawl distribution. Skin punch biopsy site on the left chest wall
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Fig2: Erythematous rash typical of dermatomyositis on the patient’s neck and shoulders in a classical shawl distribution. Skin punch biopsy site on the left chest wall

Mentions: A 69-year-old woman experienced 3 months of atypical chest pain, erythematous rash over her face and sun-exposed 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. However, clinical impression of inpatient dermatology and rheumatology consults was dermatomyositis (DM). Creatine kinase 1409 U/L and aldolase 7.6 U/L were elevated, but anti-nuclear antibodies were negative. Electromyography showed myopathic changes, muscle biopsy displayed diffuse expression of MHC class I antigen on immunostaining supportive of underlying inflammatory myopathy, and skin punch biopsy was consistent with DM (Fig. 3).Fig. 2


Paraneoplastic cerebellar degeneration and dermatomyositis as first manifestations of underlying breast malignancy: a report of two cases and a brief review of the subject.

Ng YR, Ho CD, Ng WL, Tan SM - Surg Case Rep (2015)

Erythematous rash typical of dermatomyositis on the patient’s neck and shoulders in a classical shawl distribution. Skin punch biopsy site on the left chest wall
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4560124&req=5

Fig2: Erythematous rash typical of dermatomyositis on the patient’s neck and shoulders in a classical shawl distribution. Skin punch biopsy site on the left chest wall
Mentions: A 69-year-old woman experienced 3 months of atypical chest pain, erythematous rash over her face and sun-exposed 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. However, clinical impression of inpatient dermatology and rheumatology consults was dermatomyositis (DM). Creatine kinase 1409 U/L and aldolase 7.6 U/L were elevated, but anti-nuclear antibodies were negative. Electromyography showed myopathic changes, muscle biopsy displayed diffuse expression of MHC class I antigen on immunostaining supportive of underlying inflammatory myopathy, and skin punch biopsy was consistent with DM (Fig. 3).Fig. 2

Bottom Line: 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.The rarity of these presentations highlights the necessity to include an occult malignancy in the differential diagnosis when attending to such patients.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Changi General Hospital, 2 Simei Street, Singapore, 529 889 Singapore.

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.

No MeSH data available.


Related in: MedlinePlus