Abstract
Prostate cancer is the most common cancer among American and European men. Nervous system affection caused by local tumor growth or osseous metastases are the main causes of neurological symptoms in prostate cancer patients. Prostate cancer is rarely reported in association with paraneoplastic neurological syndromes (PNS). We have, therefore, studied clinical and paraclinical findings of a series of patients with prostate cancer and PNS, and reviewed cases reported in the literature. Case histories of 14 patients with definite PNS from the PNS Euronetwork database and from the authors’ databases were reviewed. A PubMed literature search identified 23 patients with prostate cancer and PNS. Thus, a total of 37 case histories were reviewed with respect to syndrome type, cancer evolution, paraclinical investigations, antibody status, treatment and outcome. The three most frequent isolated PNS were paraneoplastic cerebellar degeneration, paraneoplastic encephalomyelitis (PEM)/limbic encephalitis and subacute sensory neuronopathy (SSN). Onconeural antibodies were detected in 23 patients, in most cases the Hu antibody (17 patients, 74 % of all antibody-positive cases). Other well-characterized onconeural antibodies (Yo, CV2/CRMP5, amphiphysin, VGCC antibodies) were found in a minority. PNS was diagnosed prior to prostate cancer diagnosis in 50 % of the cases. The association of PNS with prostate cancer is quite infrequent, but clinically important. PNS often heralds prostate cancer diagnosis. Syndromes associated with Hu antibodies predominate. Another tumor more prone to associate with PNS should always be excluded.
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Acknowledgments
The authors wish to commemorate late Dr. Ian Hart, consultant neurologist at the Walton Centre, Liverpool, UK, who first proposed this project, in appreciation of his great enthusiasm and knowledge in the field of paraneoplastic neurological disorders. The PNS Euronetwork is supported by Grants QLG1-CT-2002-01756 and LSSM-CT-2005-518174 from the European Commission.
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Dr Honnorat has a patent from INSERM to detect CV2/CRMP5 antibodies licensed to Athena diagnostics, Euroimmune, RAVO diagnostic. Otherwise, the authors have no disclosures of potential conflicts of interest.
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Inclusion of patients in the PNS EuroNetwork database was done according to national ethical regulations in each case.
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Members of the PNS EuroNetwork are given in the Appendix.
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Appendix
The PNS EuroNetwork was formed by: B. Giometto, Treviso, Italy; P. Tonali, Rome, Italy; M. C. Vigliani, Torino, Italy; J. Honnorat, Lyon, France; R. Voltz, Cologne, Germany; F. Graus, Barcelona, Spain; P. Stourac, Brno, Czech Republic; R. Fazio, Milan, Italy; P. Sillevis Smitt, Rotterdam, Netherlands; J. Verschuuren, Leiden, Netherlands; A. Carpentier, Paris, France; A. Vincent, Oxford, UK; J. C. Antoine, St. Etienne, France; J. Rees, London, UK; W. Grisold, Vienna, Austria; C. Vedeler, Bergen, Norway; R. Zoran, Ljubljana, Slovenia; (the late) Ian Hart, Liverpool, UK; L. Lorusso, Chiari, Italy; G. Bertolini, Bergamo, Italy; G. Vita, Messina, Italy; F. Blaes, Giessen, Germany; S. Rauer, Freiburg, Germany.
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Storstein, A., Raspotnig, M., Vitaliani, R. et al. Prostate cancer, Hu antibodies and paraneoplastic neurological syndromes. J Neurol 263, 1001–1007 (2016). https://doi.org/10.1007/s00415-016-8090-7
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DOI: https://doi.org/10.1007/s00415-016-8090-7