Журнал клинических случаев

Anti−Yo Associated Paraneoplastic Neurologic Syndrome in a Patient with Pelvic Tumor: A Case Report

Abstract

Nitish Beharee, Lihua Zhang and Jinhua Wang

Objective: Report a case with probable autoimmune sensorimotor neuropathy positive for serum anti-Yo antibodies.

Background: Paraneoplastic neurological syndrome occurs because of immune-mediated neuronal dysfunction secondary to systemic malignancy, and the symptoms usually occur before the malignancy is discovered. Anti-Yo antibody is known to be an onconeural antibody that causes paraneoplastic cerebellar degeneration associated with ataxia and cerebellar dysfunction and denote an underlying malignancy, usually gynecological tumors. Here, we have reported a rare case of autoimmune sensorimotor neuropathy positive for serum anti-Yo antibodies presenting with tremors, slurred speech and unstable gait, in a patient with pelvic tumor.

Case Report: A 56-year-old female patient presented with an 8 months history of upper limbs tremors, slurred speech and an unstable gait for past 6 months. Initially, the patient underwent a brain MRI, which showed mild cerebellar atrophy, paranasal sinusitis and possible right frontal endogenic small osteoma. While investigating further, the anti-Yo antibodies in serum and cerebrospinal fluid were found to be weakly positive. On ultrasound, an abnormal echogenic structure was found in the left side of the pelvic cavity, with the absence of the uterus. As such, a pelvic MRI was carried out, which showed abnormal signals in bilateral accessory areas.

Conclusion: This is a rare case of autoimmune sensorimotor neuropathy positive for serum anti-Yo antibodies in a patient with a pelvic tumor. The appearance of neurological symptoms should raise suspicions for paraneoplastic autoimmune disorders.