Abstract Details

Title Opsoclonus Myoclonus Syndrome in Uterine Malignancy

Topic Autoimmune Neurology

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 047

Objective N/a

Background Opsoclonus Myoclonus is a well-recognized paraneoplastic syndrome with spontaneous arrhythmic, saccades, brief involuntary movements associated with ataxia, dysarthria, and psychiatric manifestations. It is frequently associated with breast cancer, small cell lung cancer, thyroid cancer, and ovarian cancer in adults. Here we report an uncommon association of paraneoplastic opsoclonus myoclonus syndrome with uterine malignancy. It improves with treatment underlying malignancy and previous studies revealed recurrence of paraneoplastic syndromes prior to detection of malignancy.

Design/Methods N/A

Results Patient is a 37 year old female with no significant past medical history who presented to the hospital for evaluation of vertigo, nausea, vomiting for 3 months and progressive falls for 1 month. Neurological examination revealed opsoclonus myoclonus, titubation, bilateral finger to nose dysmetria, and bilateral upgoing plantar reflexes. MRI Brain and Orbits were negative. MRI pelvis revealed a 6.5 cm lobulated uterine mass. PET scan revealed enhancement in the uterine mass, bilateral retroperitoneal and abdominal lymphadenopathy. CSF revealed negative Anti Hu, Anti Yo, Anti Ri ab fluorescence, with reactivity to an unidentified antibody. Biopsy revealed endometrial carcinoma, p16 intensive positivity, patchy positivity of p53, CD56, synaptophysin, focal positivity PR, scant positivity ER. Patient received IVIG without improvement in symptoms. Patient received chemotherapy, debulking hysterectomy and bilateral salphingoopherectomy with improvement in symptoms. Patient reported recurrence of nausea and vertigo; imaging revealed metastatic brain lesions. Patient underwent GKR with improvement in symptoms.

Conclusions We are presenting a patient with paraneoplastic opsoclonus myoclonus syndrome with endometrial malignancy which has not been frequently reported in literature. Previously reported cases of uterine malignancy were treatment responsive as in this patient. However, this patient additionally had recurrence of symptoms prior to clinical tumor detection.

Authors/Disclosures
Maithreyi Chappidi, MD (Univrsity of Alabama Birmingham) PRESENTER	Dr. Chappidi has nothing to disclose.
Erik V. Burton, MD	Dr. Burton has nothing to disclose.

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