Neurological paraneoplastic syndromes: an update

Purpose of review To describe recent advances in the diagnosis and treatment of paraneoplastic neurological syndromes (PNS). Recent findings PNS are rare complications of cancer caused by an immune cross-reaction between antigens expressed by tumor cells and neurons. The target of the immune attack can be an intracellular antigen or a cell-surface antigen. Although both types of autoimmunity are ‘paraneoplastic’, as indirectly triggered by the presence of a tumor, they profoundly differ in terms of clinical profile, pathogenesis and outcome. PNS associated with antibodies to intracellular antigens (icPNS) are characterized by relentless progression and poor response to treatment, because of rapid and permanent neuronal loss. PNS associated with antibodies to cell-surface antigens (csPNS) generally show favorable response to immune therapy and good functional outcome, as they result from reversible neuronal dysfunction. Summary The spectrum of paraneoplastic autoimmunity has dramatically expanded following the discovery of cell-surface antibodies. Novel antibodies are incessantly discovered, some of which have a solid association with cancer. As csPNS usually respond to immune therapy, the optimization of current treatment strategies should have high priority to improve therapeutic results and prevent relapses.
Source: Current Opinion in Oncology - Category: Cancer & Oncology Tags: BRAIN AND NERVOUS SYSTEM: Edited by Marc Sanson Source Type: research

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(University of California - San Francisco) Using advanced technology, scientists at Chan Zuckerberg (CZ) Biohub, Mayo Clinic and University of California, San Francisco (UCSF), have discovered an autoimmune disease that appears to affect men with testicular cancer.Called 'testicular cancer-associated paraneoplastic encephalitis,' the disease causes severe neurological symptoms in men. They progressively lose control of their limbs, eye movements, and speech. The disease begins with a testicular tumor, which may cause the immune system to attack the brain.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
In this study, we reported the case of a 74-year-old Japanese woman who developed PLE after partial remission of small cell lung cancer (SCLC) by first-line systemic chemotherapy. Brain magnetic resonance imaging showed no metastatic tumor or cerebrovascular disease. Anti-glutamic acid decarboxylase (GAD) and anti-amphiphysin antibodies were detected in her serum. She was diagnosed as having PLE related to the recurrence of SCLC and received high-dose glucocorticoid, and sequentially systemic chemotherapy with amrubicin. Unfortunately, these treatments did not improve her disease progression and she died 4 months later. Al...
Source: Case Reports in Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsTo the best of our knowledge, renal malignancy presenting as syndrome of inappropriate antidiuretic hormone secretion and Leser –Trélat concurrently is rare. The causes of hyponatremia in the elderly, approach to investigation, and value as a poor prognostic marker in malignancy are highlighted. We also discuss Leser–Trélat syndrome, its pathophysiology, and its possible implications on clinical practice.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Cancers, Vol. 11, Pages 687: Pretreatment Cancer-Related Cognitive Impairment—Mechanisms and Outlook Cancers doi: 10.3390/cancers11050687 Authors: Brennan Olson Daniel Marks Cognitive changes are common in patients with active cancer and during its remission. This has largely been blamed on therapy-related toxicities and diagnosis-related stress, with little attention paid to the biological impact of cancer itself. A plethora of clinical studies demonstrates that cancer patients experience cognitive impairment during and after treatment. However, recent studies show that a significant portion of patients wi...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research
Katarina Rejlekova1, Maria C. Cursano2, Ugo De Giorgi3 and Michal Mego1* 12nd Department of Oncology, Faculty of Medicine, National Cancer Institute, Comenius University, Bratislava, Slovakia 2Oncology Unit, Università Campus Bio-Medico, Rome, Italy 3Medical Oncology Department, Instituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola, Italy Testicular germ cell tumors (TGCTs) represent the most common solid tumor in young men and is a model of curable cancer. The effectiveness of cisplatin-based chemotherapy secures more than 95% of patients' 5-years survival rate. Howeve...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
acute;nguez-Carrillo LG Abstract Background: Neurological paraneoplastic syndromes are rare, occur in 0.01% of all cancer patients; like part of them, the Lambert-Eaton syndrome is an autoimmune presynaptic disorder of neuromuscular transmission characterized by muscle weakness and neurovegetative dysfunction, and often associated with small cell lung cancer. Case report: A 72 years old female with a family history of lung cancer and leukemia, with 7 months of dry cough and 3 months with waist and pelvic muscle weakness, oropharyngeal dysphagia, dry mouth, chronic constipation and weight loss of 10 kg. P...
Source: Cirugia y Cirujanos - Category: Surgery Authors: Tags: Cir Cir Source Type: research
Ma2 antibody-associated encephalitis is an inflammatory brain disease that associates with a systemic tumor in more than 90% of patients, most commonly a testicular germ-cell tumor, lung cancer, or breast cancer. The Ma2 antibody-mediated autoimmune encephalitis presents mostly as limbic, mesodiencephalic, or brain stem encephalitis. Cranial MRI often detects T2-hyperintense lesions that may progress to atrophy. However, other areas of the CNS, such as the brainstem, the thalamus, the hypothalamus, the cerebellum, or the basal ganglia may also be affected. Approximately one-third of patients with Ma2 antibody-associated en...
Source: Neurology Neuroimmunology and Neuroinflammation - Category: Neurology Authors: Tags: Chorea Clinical/Scientific Notes Source Type: research
Discussion: While the incidence of melanoma of unknown primary is between 2.6 and 3.2%, with a median overall survival ranging between 24 and 127 months, when melanoma patients develop OMS their survival is markedly decreased. Although only 5 cases of paraneoplastic OMS secondary to melanoma have been reported in the literature, all had a poor prognosis, dying within 8 months of OMS onset.Case Rep Neurol 2019;11:66 –79
Source: Case Reports in Neurology - Category: Neurology Source Type: research
Abstract Ilex paraguariensis (IP) is widely consumed as tea with high nutritional value. This plant contains several bioactive phenolic compounds, which are antioxidant and anti-inflammatory. On the other hand, lung adenocarcinoma (LAC) deleteriously involves neoplastic progression, inflammatory paraneoplastic syndromes, and death. Given that brain is a frequent target of this illness, our objective was to determine the neuroprotective effect of IP consumption in LAC-bearing mice. They were orally treated with 50 mg of IP extract/kg/day (IP50) for 3 weeks. Results (phenolic compounds, lipid peroxides, inter...
Source: Nutrition and Cancer - Category: Cancer & Oncology Authors: Tags: Nutr Cancer Source Type: research
Discussion:The case clearly demonstrates poor prognostic indicators with hypercalcemia and severe leukocytosis in the setting of end stage lung adenosquamous carcinoma. Classically, paraneoplastic hypercalcemia is associated with PTHrP production in Squamous Cell carcinoma. Overall incidence of hypercalcemia in lung cancer ranges from to 8%-12% with median survival time (MST) of 3.8 months (1,2).Paraneoplastic Leukocytosis meanwhile is most often associated with adenocarcinoma (42%) and squamous cell carcinoma (36%) with incidence ranging between 16 and 30% and MST of 1.9 months (1,2). Nonetheless, the combination of these...
Source: Blood - Category: Hematology Authors: Tags: 203. Lymphocytes, Lymphocyte Activation, and Immunodeficiency, including HIV and Other Infections Source Type: research
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