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Published in: Journal of Medical Case Reports 1/2021

Open Access 01-12-2021 | Paraneoplastic Syndromes | Case report

Rare paraneoplastic syndrome of prostatic cancer: limbic encephalitis: a case report

Authors: Omar Karray, Sven Tolner, Naïm Yarak, Maguy Cherfan, Mihaela Dana Cosma, Walid Sleiman, Philippe Niclot, Jean Louis Dubost, Patrick Coloby, Stéphane Bart

Published in: Journal of Medical Case Reports | Issue 1/2021

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Abstract

Introduction

Limbic encephalitis is an autoimmune neurologic disorder, often of paraneoplastic origin, that seldom complicates prostatic tumors. The nonspecificity of symptoms makes the diagnosis sometimes difficult to establish. Prognosis is essentially determined by comorbidities and sensorineural and cognitive sequelae.

Clinical case

A 66-year-old Caucasian patient known to have prostatic small-cell neuroendocrine adenocarcinoma under hormonal therapy developed complex partial epileptic seizures associated with rapidly aggravating severe memory impairment.
The tripod of autoimmune limbic encephalitis diagnosis was based on the clinical aspect of brain’s functional deterioration, electroencephalography aspect, and γ-aminobutyric acid type B anti-receptor antibody positivity. Clinical, diagnostic, and therapeutic management as well as evolutionary risks were further analyzed.

Conclusion

Limbic encephalitis is an extremely rare presentation of neurologic paraneoplastic syndromes.
A better knowledge of this entity would help better manage diagnostic and therapeutic difficulties and reduce the risk of possible sequelae.
Literature
1.
go back to reference Mundiyanapurath S, Jarius S, Probst C, et al. GABA-B-receptor antibodies in paraneoplastic brainstem encephalitis. J Neuroimmunol. 2013;259:88–91.CrossRef Mundiyanapurath S, Jarius S, Probst C, et al. GABA-B-receptor antibodies in paraneoplastic brainstem encephalitis. J Neuroimmunol. 2013;259:88–91.CrossRef
2.
go back to reference Höftberger R, Titulaer MJ, Sabater L, Dome B, Rózsás A, Hegedus B, Hoda MA, Laszlo V, Ankersmit HJ, Harms L, Boyero S, de Felipe A, Saiz A, Dalmau J, Graus F. Encephalitis and GABA receptor antibodies: novel findings in a new case series of 20 patients. Neurology. 2013;81(17):1500–6.CrossRef Höftberger R, Titulaer MJ, Sabater L, Dome B, Rózsás A, Hegedus B, Hoda MA, Laszlo V, Ankersmit HJ, Harms L, Boyero S, de Felipe A, Saiz A, Dalmau J, Graus F. Encephalitis and GABA receptor antibodies: novel findings in a new case series of 20 patients. Neurology. 2013;81(17):1500–6.CrossRef
3.
go back to reference Jakobsen JK, Zakharia ER, Boysen AK, et al. Prostate cancer may trigger paraneoplastic limbic encephalitis: a case report and a review of the literature. Int J Urol: Off J Jpn Urol Assoc. 2013;20:734–7.CrossRef Jakobsen JK, Zakharia ER, Boysen AK, et al. Prostate cancer may trigger paraneoplastic limbic encephalitis: a case report and a review of the literature. Int J Urol: Off J Jpn Urol Assoc. 2013;20:734–7.CrossRef
4.
go back to reference Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D, CARE Group. The CARE guidelines: consensus-based clinical case reporting guideline development. J Med Case Rep. 2013;7:223.CrossRef Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D, CARE Group. The CARE guidelines: consensus-based clinical case reporting guideline development. J Med Case Rep. 2013;7:223.CrossRef
5.
go back to reference Berger JR, Bensalem M, Dalmau J. A brainstem paraneoplastic syndrome associated with prostate cancer. J Neurol Neurosurg Psychiatry. 2009;80:934–5.CrossRef Berger JR, Bensalem M, Dalmau J. A brainstem paraneoplastic syndrome associated with prostate cancer. J Neurol Neurosurg Psychiatry. 2009;80:934–5.CrossRef
6.
go back to reference Qin W, Wang X, Yang J, et al. Coexistence of Anti-SOX1 and Anti-GABAB receptor antibodies with autoimmune encephalitis in small cell lung cancer: a case report. Clin Interv Aging. 2020;7(15):171–5.CrossRef Qin W, Wang X, Yang J, et al. Coexistence of Anti-SOX1 and Anti-GABAB receptor antibodies with autoimmune encephalitis in small cell lung cancer: a case report. Clin Interv Aging. 2020;7(15):171–5.CrossRef
7.
go back to reference Graus F, Keime-Guibert F, Rene R, et al. Anti-Hu-associated paraneoplastic encephalomyelitis: analysis of 200 patients. Brain. 2001;124(Pt 6):1138–48.CrossRef Graus F, Keime-Guibert F, Rene R, et al. Anti-Hu-associated paraneoplastic encephalomyelitis: analysis of 200 patients. Brain. 2001;124(Pt 6):1138–48.CrossRef
8.
go back to reference De Broucker T. Paraneoplastic and autoimmune encephalitis when to consider and how to diagnose it. Reanimation. 2011;20:24250. De Broucker T. Paraneoplastic and autoimmune encephalitis when to consider and how to diagnose it. Reanimation. 2011;20:24250.
9.
go back to reference Lancaster E, Lai M, Peng X, Hughes E, Constantinescu R, Raizer J, et al. Antibodies to the GABA(B) receptor in limbic encephalitis with seizures: case series and characterisation of the antigen. Lancet Neurol. 2010;9:67–76.CrossRef Lancaster E, Lai M, Peng X, Hughes E, Constantinescu R, Raizer J, et al. Antibodies to the GABA(B) receptor in limbic encephalitis with seizures: case series and characterisation of the antigen. Lancet Neurol. 2010;9:67–76.CrossRef
10.
go back to reference Leyhe T, Schule R, Schwarzler F, Gasser T, Haarmeier T. Second primary tumor in anti-Ma1/2-positive paraneoplastic limbic encephalitis. J Neurooncol. 2006;78:49–51.CrossRef Leyhe T, Schule R, Schwarzler F, Gasser T, Haarmeier T. Second primary tumor in anti-Ma1/2-positive paraneoplastic limbic encephalitis. J Neurooncol. 2006;78:49–51.CrossRef
11.
go back to reference Stern RC, Hulette CM. Paraneoplastic limbic encephalitis associated with small cell carcinoma of the prostate. Mod Pathol. 1999;12:814–8.PubMed Stern RC, Hulette CM. Paraneoplastic limbic encephalitis associated with small cell carcinoma of the prostate. Mod Pathol. 1999;12:814–8.PubMed
12.
go back to reference Alberti C. Neuroendocrine differentiation in prostate carcinoma: focusing on its pathophysiologic mechanisms and pathological features. G Chir. 2010;31:568–74.PubMed Alberti C. Neuroendocrine differentiation in prostate carcinoma: focusing on its pathophysiologic mechanisms and pathological features. G Chir. 2010;31:568–74.PubMed
13.
go back to reference Grisold W, Giometto B, Vitaliani R, Oberndorfer S. Current approaches to the treatment of paraneoplastic encephalitis. Ther Adv Neurol Disord. 2011;4:237–48.CrossRef Grisold W, Giometto B, Vitaliani R, Oberndorfer S. Current approaches to the treatment of paraneoplastic encephalitis. Ther Adv Neurol Disord. 2011;4:237–48.CrossRef
14.
go back to reference Lin J, Li C, Li A, et al. Encephalitis with antibodies against the GABAB receptor: high mortality and risk factors. Front Neurol. 2019;26(10):1030.CrossRef Lin J, Li C, Li A, et al. Encephalitis with antibodies against the GABAB receptor: high mortality and risk factors. Front Neurol. 2019;26(10):1030.CrossRef
Metadata
Title
Rare paraneoplastic syndrome of prostatic cancer: limbic encephalitis: a case report
Authors
Omar Karray
Sven Tolner
Naïm Yarak
Maguy Cherfan
Mihaela Dana Cosma
Walid Sleiman
Philippe Niclot
Jean Louis Dubost
Patrick Coloby
Stéphane Bart
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2021
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-021-02975-3

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