Abstract General Information

Title

Neuro-otological paraneoplastic syndromes: A new neuroimmunological differential diagnosis

Abstract

Paraneoplastic neurological syndromes (PNS) are immunemediated complications of cancer. The aim of the present paper is to discuss available reports for which investigation revealed a paraneoplastic cause that, although rare, should be considered in differential diagnosis. In a study involving patients with primary thymic neoplasm, hearing loss was identified as a PNS in two cases and the serological findings showed the presence of ganglionic AChR, VGKC and GAD65 antibodies. Another 2 different cases described hearing loss and neurological symptoms as a PNS secondary to a small cell lung carcinoma, in which both anti-Hu antibodies were detected in the cerebrospinal fluid. Also 3 more cases described PNS and neurological disorders. One, developed hearing loss before the identification of lymphoma recurrence in the chest wall. The second had sudden asymmetric hearing loss and a 12-cm renal mass and the third case presented with fluctuating bilateral hearing loss before a thymoma was identified. These case reports show the importance of considering PNS in differential diagnosis and with the progressive description of novel antibodies associated to PNS, as well as with improved access to the relevant antibody panel, a flowchart model for patients with suspected PNS is suggested. So, although rare, considering PNS is critical in patients with neuro-otological symptoms, as it can lead to early identification of an undiagnosed malignancy and increase the patient's chance of survival.