Published online Dec 6, 2019. doi: 10.12998/wjcc.v7.i23.4052
Peer-review started: October 5, 2019
First decision: October 23, 2019
Revised: October 26, 2019
Accepted: October 30, 2019
Article in press: October 30, 2019
Published online: December 6, 2019
Processing time: 62 Days and 10.3 Hours
Paraneoplastic neurological syndrome manifesting as secondary Parkinson disease caused by breast cancer is extremely rare.
We report a 39-year-old primipara of 31 gestational weeks, who presented with worsening tremors, facial stiffness and speech disfluencies, and decreased limb strength. Thorough physical examinations and auxiliary tests suggested secondary Parkinson’s disease, but the pathogenesis was unknown. During the cesarean section at the 31 weeks plus 6 d, an exploration and liver biopsy revealed a metastatic, poorly differentiated adenocarcinoma. The positron emission tomography and immunohistochemical analysis confirmed a breast ductal carcinoma of stage IV. To our knowledge, only two reports have documented the association between the breast cancer and the Parkinson disease, and neither occurred in pregnant women.
Our case alerts the secondary Parkinson disease as the possible presentation of breast cancer, the most common malignancy during pregnancy.
Core tip: We described a rare case of severe secondary Parkinson disease which deteriorated during pregnancy. The underlying pathogenesis was confirmed to be breast cancer, which resulted in paraneoplastic neurological syndrome (PNS). Recognition of the variable manifestations of PNS is as important as diagnosis at earlier stages of the underlying malignancy and facilitates prompt treatment to improve prognosis.