PMID- 36483902
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221210
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 11
DP  - 2022 Nov
TI  - An Etiological Investigation of Paraneoplastic Cerebellar Degeneration in Ovarian 
      Cancer Patients: A Systematic Review.
PG  - e31154
LID - 10.7759/cureus.31154 [doi]
LID - e31154
AB  - Paraneoplastic syndromes (PNS) are uncommon, distinct clinical complications of a 
      primary tumor. Paraneoplastic cerebellar degeneration (PCD) is a PNS that is 
      described as an autoimmune response targeting Purkinje cells in the cerebellum. 
      Ovarian cancer (OC) is one of the most prevalent causes of cancer-related deaths 
      in women. Anti-Yo is the most common onconeural antibody produced in the PCD 
      immune response and is most typically found in ovarian and breast cancer 
      patients. While the current literature highlights the predisposing genetic 
      factors, diagnostic workflows, and treatment options, the pathophysiology of PCD, 
      among other considerations, remains largely unestablished. This review aimed to 
      systematically observe procedural solutions to facilitate an early diagnosis and 
      improve the prognosis of patients with OC-associated PCD. To that end, we 
      examined literature published from 01/01/2015-11/10/2022 indexed in PubMed by 
      using the keywords "paraneoplastic, cerebellar degeneration" combined with 
      "ovarian cancer." Inclusion criteria were met if PCD and OC diagnoses were made 
      and if studies provided adequate patient information. After screening and 
      assessing records for eligibility using the inclusion and exclusion criteria, 18 
      articles involving 102 patients were included. The typical patient observed in 
      this sample was diagnosed with International Federation of Gynecology and 
      Obstetrics (FIGO) Stage III, high-grade serous carcinoma. The diagnostic workup 
      typically included a clinical evaluation for dysarthria (50%), ataxia (60%), and 
      gait abnormalities (50%), along with multiple imaging modalities and serological 
      findings (90%). Genetic screening for human leukocyte antigen (HLA) haplotype 
      susceptibility for PCD and immune tolerance modulators regulation may also be 
      recommended prior to starting treatment. Findings support the use of 
      corticosteroids (35%) and intravenous immunoglobulin (IVIg) (40%) as viable 
      treatment options for managing PCD in conjunction with systemic therapy for the 
      primary malignancy. A diagnosis of PCD should be considered if a patient has had 
      a malignancy in the past five years with the presence of explicit cerebellar 
      symptoms. This clinical diagnosis can be further supplemented by serologic and 
      radiologic findings. Recognizing PCD symptoms and scheduling genetic and 
      proteomic testing may help with early diagnosis and better prognosis.
CI  - Copyright (c) 2022, Fidahussain et al.
FAU - Fidahussain, Akbar A
AU  - Fidahussain AA
AD  - Biomedical Engineering, Saint Louis University, St. Louis, USA.
FAU - Abid, Ali
AU  - Abid A
AD  - Biology, Saint Louis University, St. Louis, USA.
FAU - Paracha, Awais A
AU  - Paracha AA
AD  - Hematology and Oncology, Saint Louis University School of Medicine, St. Louis, 
      USA.
FAU - Jeevan, Varun E
AU  - Jeevan VE
AD  - Neurology, University of Missouri School of Medicine, Columbia, USA.
FAU - Rueve, Joseph
AU  - Rueve J
AD  - Biology, Saint Louis University, St. Louis, USA.
FAU - Engelhardt, Mckimmon
AU  - Engelhardt M
AD  - Biology, Saint Louis University, St. Louis, USA.
FAU - Schrock, Cody
AU  - Schrock C
AD  - Neuroscience, Saint Louis University, St. Louis, USA.
FAU - Ghani, Sofia
AU  - Ghani S
AD  - Hematology and Oncology, Saint Louis University School of Medicine, St. Louis, 
      USA.
FAU - Nair, Hari K
AU  - Nair HK
AD  - Hematology and Oncology, Saint Louis University School of Medicine, St. Louis, 
      USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20221106
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9724195
OTO - NOTNLM
OT  - anti-yo
OT  - autoimmune response
OT  - dysarthria
OT  - gait abnormalities
OT  - malignancy
OT  - neurological manifestations
OT  - onconeural antibody
OT  - ovarian cancer
OT  - paraneoplastic cerebellar degeneration
OT  - serous carcinoma
COIS- The authors have declared financial relationships, which are detailed in the next 
      section.
EDAT- 2022/12/10 06:00
MHDA- 2022/12/10 06:01
PMCR- 2022/11/06
CRDT- 2022/12/09 04:13
PHST- 2022/11/05 00:00 [accepted]
PHST- 2022/12/09 04:13 [entrez]
PHST- 2022/12/10 06:00 [pubmed]
PHST- 2022/12/10 06:01 [medline]
PHST- 2022/11/06 00:00 [pmc-release]
AID - 10.7759/cureus.31154 [doi]
PST - epublish
SO  - Cureus. 2022 Nov 6;14(11):e31154. doi: 10.7759/cureus.31154. eCollection 2022 
      Nov.