Lower motor neuron syndrome in a patient with HER2-positive metastatic breast cancer: A case report and review of the literature

Clin Neurol Neurosurg. 2018 Sep:172:141-142. doi: 10.1016/j.clineuro.2018.06.038. Epub 2018 Jul 6.

Abstract

Paraneoplastic neurological syndromes are very rare and often associated to breast, ovarian and small cells lung cancers. Paraneoplastic motor neuron diseases (MNDs) are even rarer, and frequently described in patients with breast cancer. We presented the first case of patient affected by HER2-positive breast tumor and possible paraneoplastic lower motor neuron disease. In literature, few cases are reported but no one highlights the tumor receptors' profile. Instead, HER2-positive breast cancers are prone to be related to anti-Yo-associated paraneoplastic cerebellar disorders. Anti-onconeural antibodies positivity can be rarely found, confirming that paraneoplastic MND have no specific biomarkers. The presence of CSF oligoclonal bands (OBs) suggests the presence of immune-mediated mechanism, in absence of other possible OBs causes.

Keywords: CSF oligoclonal bands; HER2-positive breast cancer; Lower motor neuron syndrome; Paraneoplastic syndrome.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Autoantibodies / cerebrospinal fluid
  • Breast Neoplasms / cerebrospinal fluid*
  • Breast Neoplasms / complications
  • Breast Neoplasms / genetics
  • Humans
  • Motor Neuron Disease / cerebrospinal fluid*
  • Motor Neuron Disease / diagnosis
  • Motor Neuron Disease / genetics
  • Motor Neurons
  • Neoplasm Metastasis / pathology*
  • Nerve Tissue Proteins / genetics
  • Oligoclonal Bands / cerebrospinal fluid*
  • Paraneoplastic Syndromes / cerebrospinal fluid*
  • Paraneoplastic Syndromes / diagnosis
  • Paraneoplastic Syndromes / genetics
  • Receptor, ErbB-2 / genetics*

Substances

  • Autoantibodies
  • Nerve Tissue Proteins
  • Oligoclonal Bands
  • ERBB2 protein, human
  • Receptor, ErbB-2