Home Duke University Press
QUICK SEARCH:   [advanced]


     
  Home | Help | Feedback | Subscriptions | Archive | Search | Table of Contents

Neuro Oncol 2002 4(3):192-195; DOI:10.1215/15228517-4-3-192
This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (6)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Tremont-Lukats, I. W.
Right arrow Articles by Groves, M. D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Duke University Press

Medical Neuro-Oncology

Paraneoplastic chorea: Case study with autopsy confirmation

Ivo W. Tremont-Lukats, Gregory N. Fuller, Teresa Ribalta, Pierre Giglio and Morris D. Groves1

Neuro-Oncology Department (I.W.T.-L., P.G., M.D.G.), Sections of Neuropathology and Immunocytochemistry (G.N.F.), the University of Texas M.D. Anderson Cancer Center, Houston, TX 77030; and Anatomia Patológica, Universitat de Barcelona, Barcelona, Spain (T.R.)

1 Address correspondence and reprint requests to Morris D. Groves, Department of Neuro-Oncology, the University of Texas M.D. Anderson Cancer Center, Houston, TX 77030.

Abstract

A 67-year-old man presented with a 7-month history of insidiously progressive chorea, ataxia, and vertigo. Neurologic examination revealed deficits referable to the basal nuclei, cerebellar vermis, and vestibular nuclei. Small-cell lung cancer was diagnosed by fine-needle biopsy of a parahilar mass. After chemotherapy, the patient's chorea worsened. Anti-Hu antibodies were present in serum and cerebrospinal fluid. Microscopic examination of the brain at autopsy revealed diffuse perivascular lymphocytic infiltrates, microglial activation, and neuronophagia throughout the neuraxis, including the brainstem, cerebellum, lenticular nuclei, striatum, and cerebral cortex. Prominent loss of Purkinje cells was seen in the cerebellar vermis and hemispheres to a lesser degree. Chorea is extremely rare as a paraneoplastic manifestation of cancer. The florid presentation and the positive findings contrasted with an unremarkable MRI of the brain. This case illustrates the preeminence of symptoms and signs over negative MRI findings in paraneoplastic encephalitis.

References

Albin, R.L., Bromberg, M.B., Penney, J.B., and Knapp. R. (1988) Chorea and dystonia: A remote effect of carcinoma. Mov. Disord. 3,162 -169.[CrossRef][Medline]

Batchelor, T.T., Platten, M., Palmer-Toy, D.E., Hunter, G.J., Lev, M.H., Dalman, J., and Hochberg, F.H. (1998) Chorea as a paraneoplastic complication of Hodgkin's disease. J. Neurooncol. 36,185 -190.[CrossRef][Medline]

Croteau, D., Owainati, A., Dalmau, J., and Rogers, L.R. (2001) Response to cancer therapy in a patient with a paraneoplastic choreiform disorder. Neurology 57,719 -722.[Abstract/Free Full Text]

Dalmau, J., Gultekin, H.S., and Posner, J.B. (1999) Paraneoplastic neurologic syndromes: Pathogenesis and physiopathology. Brain Pathol. 9,275 -284.[Web of Science][Medline]

Graus, F., Ribalta, T., Campo, E., Monforte, R., Urbano, A., and Rozman, C. (1990) Immunohistochemical analysis of the immune reaction in the nervous system in paraneoplastic encephalomyelitis. Neurology 40,219 -222.[Abstract/Free Full Text]

Graus, F., Keime-Guibert, F., Rene, R., Benyahia, B., Ribalta, T., Ascaso, C., Escaramis, G., and Delattre, J.Y. (2001) Anti-Hu-associated paraneoplastic encephalomyelitis: Analysis of 200 patients. Brain 124,1138 -1148.[Abstract/Free Full Text]

Heckmann, J.G., Lang, C.J., Druschky, A., Claus, D., Bartels, O., and Neundorfer, B. (1997) Chorea resulting from paraneoplastic encephalitis. Mov. Disord. 12,464 -466.[CrossRef][Medline]

Henson, R.A., and Urich, H. (1982) Cancer and the Nervous System: The Neurological Manifestations of Systemic Malignant Disease. Oxford: Blackwell Scientific.

Kujawa, K.A., Niemi, V.R., Tomasi, M.A., Mayer, N.W., Cochran, E., and Goetz, C.G. (2001) Ballistic-choreic movements as the presenting feature of renal cancer. Arch. Neurol. 58,1133 -1135.[Abstract/Free Full Text]

Posner, J.B. (1995) Neurologic Complications of Cancer. Contemporary Neurology Series 45. Philadelphia: F.A. Davis. pp. 353-385.

Scaravilli, F., An, S.F., Groves, M., and Thom, M. (1999) The neuropathology of paraneoplastic syndromes. Brain Pathol. 9,251 -260.[Medline]

Tani, T., Piao, Y., Mori, S., Ishihara, N., Tanaka, K.I., Wakabayashi, K., and Takahashi, H. (2000) Chorea resulting from paraneoplastic striatal encephalitis. J. Neurol. Neurosurg. Psychiatry 69,512 -515.[Abstract/Free Full Text]


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 J. Neurol. Neurosurg. PsychiatryHome page
A Saiz, J Bruna, P Stourac, M C Vigliani, B Giometto, W Grisold, J Honnorat, D Psimaras, R Voltz, and F Graus
Anti-Hu-associated brainstem encephalitis
J. Neurol. Neurosurg. Psychiatry, April 1, 2009; 80(4): 404 - 407.
[Abstract] [Full Text] [PDF]

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (6)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Tremont-Lukats, I. W.
Right arrow Articles by Groves, M. D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

  Home | Help | Feedback | Subscriptions | Archive | Search | Table of Contents


Copyright 2002 by Society for Neuro-Oncology