Anti-Zic4 Paraneoplastic Cerebellar Degeneration With Mesial Temporal Lobe Hyperintensity in a Patient With Papillary Thyroid Carcinoma: A Case Report and Review of the Literature.
case report
onconeural antibodies
papillary thyroid carcinoma
paraneoplastic cerebellar degeneration
paraneoplastic neurological syndrome
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
accepted:
14
03
2023
medline:
18
4
2023
entrez:
17
4
2023
pubmed:
18
4
2023
Statut:
epublish
Résumé
Paraneoplastic cerebellar degeneration (PCD), a subtype of paraneoplastic neurological syndromes (PNSs), is a rare autoimmune neurologic syndrome that usually develops secondary to an underlying malignancy. We present a 49-year-old patient that developed PCD secondary to occult papillary thyroid carcinoma. The patient had progressive difficulty ambulating for 3 years. A neurological exam revealed signs of cerebellar syndrome. Brain magnetic resonance imaging (MRI) showed significant cerebellar atrophy and mesial temporal lobe hyperintensity. Immunological testing was highly positive for anti-CV2 and anti-Zic4 onconeural antibodies. Positron emission tomography (PET)/Computerized tomography (CT) scan revealed significant hypermetabolic uptake of F-18 fluorodeoxyglucose (FGD) by a left thyroid nodule. Histological examination of the nodule was positive for papillary thyroid carcinoma, confirming the diagnosis of PCD. A trial of high-dose methylprednisolone failed to improve the patient's symptoms. This case highlights the importance of maintaining high suspicion for PCD while investigating cases of cerebellar degeneration. Early detection is essential to prevent irreversible damage in affected patients.
Identifiants
pubmed: 37065299
doi: 10.7759/cureus.36164
pmc: PMC10102830
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e36164Informations de copyright
Copyright © 2023, Abuzahra et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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