Occult breast carcinoma presenting as paraneoplastic opsoclonus-myoclonus-ataxia syndrome.
Syed Adil Hassan, Aswini Bezbaruah, Dipjyoti Payeng et al.
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Case in brief
A woman in her sixties presented with subacute opsoclonus and gait ataxia, leading to the diagnosis of opsoclonus-myoclonus-ataxia syndrome (OMAS). Despite extensive imaging, no primary breast lesion was found, revealing only metastatic carcinoma in the left axillary lymph nodes. The patient's neurological symptoms improved significantly after treatment with corticosteroids and intravenous immunoglobulin.
What made this case unusual
This case highlights an atypical presentation of antibody-negative paraneoplastic OMAS associated with occult breast carcinoma, where the malignancy was only evident in axillary lymph nodes.
Diagnostic / clinical pearl
Clinicians should consider the possibility of occult malignancies in patients presenting with opsoclonus-myoclonus-ataxia syndrome, even when initial imaging does not reveal a primary tumor.
Why it matters
Recognizing this association can lead to timely diagnosis and management of underlying malignancies, potentially improving patient outcomes.