Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2022; 10(32): 11827-11834
Published online Nov 16, 2022. doi: 10.12998/wjcc.v10.i32.11827
Paraneoplastic neurological syndrome caused by cystitis glandularis: A case report and literature review
Dong-Hui Zhao, Qing-Jun Li
Dong-Hui Zhao, Department of Pathology, University of Chinese Academy of Sciences-Shenzhen Hospital, Shenzhen518000, Guangdong Province, China
Qing-Jun Li, Department of Neurology, University of Chinese Academy of Sciences-Shenzhen Hospital, Shenzhen518000, Guangdong Province, China
Author contributions: Zhao DH contributed to manuscript writing and editing, pathological data collection and analysis; Li QJ contributed to manuscript editing, clinical data collection and analysis; all authors have read and approved the final manuscript.
Supported by Shenzhen Guangming District Special Fund for Economic Development, China, No. 2020R01006; and University of Chinese Academy of Sciences-Shenzhen Hospital Discipline Construction Capacity Improvement Project, No. HRF-2020023.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors report no relevant conflict of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qing-Jun Li, PhD, Chief Doctor, Department of Neurology, University of Chinese Academy of Sciences-Shenzhen Hospital, No. 4253 Songbai Road, Shenzhen 518000, Guangdong Province, China. 527718815@qq.com
Received: June 30, 2022
Peer-review started: June 30, 2022
First decision: August 4, 2022
Revised: August 11, 2022
Accepted: September 19, 2022
Article in press: September 19, 2022
Published online: November 16, 2022
Processing time: 130 Days and 22.3 Hours
Abstract
BACKGROUND

Paraneoplastic neurological syndrome (PNS) is an unusual event. PNS caused by cystitis glandularis (CG) or a bladder tumor is extremely rare; hence, missed diagnosis or misdiagnosis can easily occur. To date, approximately 21 cases have been reported in PubMed.

CASE SUMMARY

We report a case of PNS caused by CG and describe the clinical and imaging features. The main clinical feature was advanced cognitive impairment, and early clinical features were memory impairment, decreased computational ability, and abnormal behavior. Later clinical features were dementia, vomiting, inability to eat and walk, urinary incontinence, and hematuria. Imaging features on cranial magnetic resonance imaging were diffuse white matter lesions. Paraneoplastic tumor markers were normal. A total abdominal computed tomography scan showed multiple thickened areas on the bladder wall with local prominence. Cystoscopy revealed a volcanic protuberance on the posterior wall of the bladder with a diameter of 6 cm and no pedicle. The postoperative pathological diagnosis was CG. The patient recovered well following resection of CG. PNS cases caused by previous bladder tumors can be retrieved from PubMed to describe the clinical signs and prognosis of PNS.

CONCLUSION

The main clinical feature of PNS caused by CG was dementia, and the imaging features were diffuse cerebral white matter lesions. Resection of CG lesions is the fundamental treatment for PNS induced by CG. This case highlights the importance of etiological treatment.

Keywords: Cystitis glandularis; Paraneoplastic neurological syndrome; Dementia; Magnetic resonance imaging; Cerebral white matter disease; Bladder tumor; Case report

Core Tip: Paraneoplastic neurological syndrome (PNS) caused by a bladder tumor is an unusual event, and PNS caused by cystitis glandularis (CG) is extremely rare.CG is considered a precancerous lesion of bladder cancer. In this case combined with an analysis of cases indexed in PubMed, the main clinical feature of PNS caused by CG is advanced cognitive impairment. The imaging features on cranial magnetic resonance imaging are diffuse white matter lesions. Resection of CG lesions is the fundamental treatment for PNS induced by CG. However, most clinicians did not consider that PNS was caused by CG and gave symptomatic supportive treatment, which resulted in long delays in diagnosis and appropriate treatment.