Paraneoplastic cerebellar degeneration is a rare complication of cancer and
is most frequently associated with lung, ovary, and breast cancers as well
as Hodgkins lymphoma. A 74-year-old female with a past history of breast c
ancer presented with vomiting, ataxia, slurred speech, and dizziness. Her s
erum chemistry, thyroid and liver function tests, acetylcholine antibodies,
serum cortisol, CT, and MRI imaging were all normal. Serum testing for ant
i-YO antibodies was positive, Further evaluation including CT of the abdome
n and pelvis revealed endometrial thickening. Subsequently, an endometrial
biopsy showed a poorly differentiated serous adenocarcinoma. Surgical stagi
ng was consistent with a stage IIIc serous adenocarcinoma of the uterus. Th
e risk factors, symptoms, signs, differential diagnosis, and clinical and a
ntibody associations of the paraneoplastic cerebellar degeneration syndrome
are reviewed. In addition, an efficient approach to the diagnostic evaluat
ion of such patients is proposed. (C) 1999 Academic Press.