A Case of Breast Cancer Presented with Paraneoplastic Neurological Syndromes

Abstract

This paper deals with a patient who presented with paraneoplastic neurological syndromes (PNS) and was diagnosed with breast cancer by general examinations, whose PNS symptoms were improved after surgery for breast cancer. A 64-year-old woman presented with bilateral femoral pain, followed by progressive bilateral upper limb tremor, diplopia, eye movement disease, and myoclonus of the bilateral lower limbs. Anti-Ri antibody positive was clarified. Accordingly, paraneoplastic opsoclonus-myoclonus syndrome, a type of PNS, was diagnosed. General exploration disclosed that she had right breast cancer. We performed right Bt + SN. The postoperative diagnosis was made as pT1cN0M0 (invasive ductal carcinoma, ER 100%, PgR 100%, HER2 negative, and Ki-67.5%). The patient was given oral anastrozole after the operation. Within one month after the operation, her eye nystagmus, diplopia, limited eye movements were relieved. Thereafter, she developed muscular rigidity and was diagnosed with stiff-person syndrome. Intramedullary baclofen administration was sustained that led to an improving tendency of ADL. In treating a patient who manifests a variety of neurologic symptoms before and/or after diagnosis of breast cancer, PNS should be considered as a possible differential diagnosis.