Yoshitomo Sato, MD, Kiyohumi Ohi, MD, Akira Takahashi, MD, Hanae Murakami, MD, Miyuki Murata, MD, Tatunori Natori, MD,
Hisashi Yonezawa, MD, Yasuo Terayama, MD
Jpn J Compr Rehabil Sci 6: 113-117, 2015
We report a case of paraneoplastic syndrome (PNS) definitively diagnosed after the patientfs previous doctor requested a detailed examination when her ataxia worsened during rehabilitation in the recovery stage. Exacerbation of limb ataxia and positive results for anti-neural antibodies were suggestive of PNS, but no clear neoplastic lesion could be identified on systematic examination, so the patient was admitted to the recovery-stage rehabilitation ward without definitive diagnosis. She underwent another detailed examination when ataxia worsened after starting rehabilitation, leading to a diagnosis of gynecological malignant tumor based on fluorodeoxyglucose positron emission tomography (FDG-PET). The patient underwent hysterectomy and bilateral salpingo-oophorectomy, which confirmed the presence of PNS concomitant with serous adenocarcinoma of the left ovary. Although the numbers are low, patients on recovery-stage rehabilitation wards usually have unstable neurological disorders. Anti-Yo antibody-positive PNS often shows a poor prognosis, and when ataxia worsens after starting rehabilitation, differentiating PNS early to make a definitive diagnosis can influence the prognosis. We report this rare case of PNS.
Key words: paraneoplastic syndrome, ataxia, CA- 125, anti-Yo antibody, rehabilitation in recovery stage