Abstract
We report a 40-year-old man with severe hypokinesis as paraneoplastic manifestation of a microscopic "carcinoma in situ" of the testis. The young age of the patient, along with progressive neurologic deterioration, detection of anti-Ma2 antibodies, and ultrasound findings of bilateral microcalcifications, led to bilateral orchiectomy, revealing the tumor in both testes. After orchiectomy, neurological symptoms stabilized, but the patient eventually died of systemic complications caused by his severe neurological deficits. Anti-Ma2 paraneoplastic encephalitis should be considered in patients with severe hypokinesis, and intensive investigation and aggressive approach to treatment is encouraged to prevent progression of the neurological deficits.
MeSH terms
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Adult
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Antigens, Neoplasm / immunology*
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Autoantibodies / blood*
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Brain / immunology
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Brain / pathology
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Carcinoma in Situ / diagnosis*
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Carcinoma in Situ / immunology
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Carcinoma in Situ / pathology
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Carcinoma in Situ / surgery
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Disease Progression
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Fatal Outcome
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Humans
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Hypokinesia / diagnosis*
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Hypokinesia / immunology
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Hypokinesia / pathology
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Limbic Encephalitis / diagnosis*
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Limbic Encephalitis / immunology
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Limbic Encephalitis / pathology
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Magnetic Resonance Imaging
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Male
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Neoplasms, Germ Cell and Embryonal / diagnosis*
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Neoplasms, Germ Cell and Embryonal / immunology
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Neoplasms, Germ Cell and Embryonal / pathology
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Neoplasms, Germ Cell and Embryonal / surgery
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Nerve Tissue Proteins / immunology*
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Orchiectomy
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Paraneoplastic Syndromes / diagnosis*
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Paraneoplastic Syndromes / immunology
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Paraneoplastic Syndromes / pathology
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Seminiferous Tubules* / pathology
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Testicular Neoplasms / diagnosis*
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Testicular Neoplasms / immunology
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Testicular Neoplasms / pathology
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Testicular Neoplasms / surgery
Substances
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Antigens, Neoplasm
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Autoantibodies
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Ma2 antigen
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Nerve Tissue Proteins