Objective: report the case of a young woman who presented with rapidly progressive ataxia caused by an ovarian teratoma

Background: paraneoplastic cerebellar degeneration (PCD) is the most devastating and easily recognized paraneoplastic syndrome. Generally, it is associated with various types of cancer, mainly gynecological and lung cancers.

Method: a case report

Results: a woman in her mild thirties, with no personal nor familial medical history, presented with a rapidly progressive ataxia over the past year. Her examination was significant for cerebellar dysarthria, gait ataxia, limb dysmetria predominantly on the right side, head tremor and generalized hyperreflexia. Otherwise, the patient was alert, had no cognitive disturbance and no motor weakness. The ophthalmological examination was normal. Magnetic resonance imaging of the brain showed a prominent olivo-ponto-cerebellar atrophy. Electroneuromyography was normal. A large panel of laboratory tests including thyroid hormone levels, vitamin B1 and E dosage, immunological workup, tumor markers and paraneoplastic antibodies were unremarkable. A computed tomographic scan of her abdomen and pelvis revealed a 5 centimeter left adnexal mass suggestive of ovarian teratoma. The patient underwent a surgical removal of her left ovary. Soon after the surgery, a significant improvement of the head tremor and the limb ataxia was noted.

Conclusion: we postulate that probably there is common immunological pathways between the teratoma and the cerebellar ataxia. Thus, clinicians should consider ovarian teratoma as a possible cause of paraneoplastic syndrome in young women with rapidly progressive ataxia.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/paraneoplastic-cerebellar-ataxia-due-to-ovarian-teratoma-a-case-report/