Serous adenocarcinoma of the uterus presenting as paraneoplastic cerebellar degeneration

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.