Metastatic "burned out" seminoma causing neurological paraneoplastic syndrome-not quite "burned out"

Yuval Freifeld, Payal Kapur, Ritika Chitkara, Francesca Lee, Pravin Khemani, Aditya Bagrodia

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

A 44-year-old man presented with cerebellar ataxia and limbic encephalitis and was ultimately diagnosed with metastatic germ cell neoplasm resulting from a "burned out" primary testicular tumor. The patient had progressive ataxia, leading to a thorough investigation for infectious, autoimmune, metabolic, and malignant causes of acquired cerebellar ataxia that revealed no significant findings. Testicular sonography demonstrated a possible right testicular lesion that was not confirmed on radical inguinal orchiectomy. F18-FDG positron emission tomography/computerized tomography scan revealed a solitary retroperitoneal lesion, concerning for metastatic disease but not amenable to percutaneous biopsy. A robotic retroperitoneal lymph node dissection was performed and pathology revealed a CD117-positive metastatic seminoma leading to appropriate germ cell tumor-directed chemotherapy. After completing chemotherapy and during 1 year of follow-up, there has been a gradual improvement of the patient's neurological manifestations.

Original languageEnglish (US)
Article number20
JournalFrontiers in Neurology
Volume9
Issue numberJAN
DOIs
StatePublished - Jan 30 2018

Keywords

  • Burned out tumor
  • Cerebellar ataxia
  • Germ cell tumor
  • Limbic encephalitis
  • Testicular cancer

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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