AB150. Paraneoplastic cerebellar degeneration: an uncommon manifestation of urothelial carcinoma in situ of the urinary bladder

Objective: Paraneoplastic neurological syndromes (PNS) are a series of rare disorders associated with malignant tumors, which are triggered by autoimmune reactions. Paraneoplastic cerebellar degeneration (PCD) is a type of PNS most commonly associated with ovarian and breast cancer. Two bladder cancers manifesting with PCD were previously reported. However, the cancers in these cases had a poor outcome.

Methods: Here we present a 68-year-old man who was diagnosed with high-grade papillary urothelial carcinoma of bladder. Five months after transurethral resection of bladder tumor (TURBt), the patient suffered from persistent cerebellar ataxia accompanied by recurrence of the bladder cancer.

Results: Laboratory examination screening the specific antibodies of PNS revealed no positive results. The patient’s symptoms were not remitted after a 7-day-course of high-dose glucocorticoid therapy. To our surprise, the patient was perfectly recovered after laparoscopic radical cystectomy. The postoperative pathology revealed the surgical specimens were the urothelial carcinoma in situ (CIS) of the bladder.

Conclusions: To our knowledge, this is the third report of a PCD in a patient with bladder cancer, and the first case addressing the relationship between PCD and urothelial CIS of the bladder. This case also showed that resection of tumor cured the PCD. Furthermore, in order to assist clinical evaluation and management, the basic characteristics of PNS and bladder cancers were summarized via literature review.

Keywords: Paraneoplastic cerebellar degeneration (PCD); carcinoma in situ (CIS); bladder cancer