Caspian Journal of Surgery

Caspian Journal of Surgery

A Probable Paraneoplastic Cerebellar Degeneration during Neoadjuvant Chemotherapy in High-Grade Serous Ovarian Carcinoma: A CARE-Compliant Case Report

Articles in Press

Document Type : Case Report

Authors
Soheila Abbaszadeh 1
shahla yazdani 1
Ariya Abedisamakoosh 1
mina galeshi 2
Mohammad Ranaei 1
Majid nabipour 1
1 Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
2 Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol,I.R.Iran
10.22088/caspjs.2026.2087114.1052
Abstract
Background:

Paraneoplastic neurological syndromes (PNS) are rare immune-mediated disorders associated with malignancies, often preceding or complicating cancer diagnosis and treatment. Among them, paraneoplastic cerebellar degeneration (PCD) is a severe subtype.

Case Presentation:

A 41-year-old woman with high-grade serous ovarian carcinoma developed progressive cerebellar symptoms including dizziness, diplopia, gait instability, and dysarthria approximately two months after initiation of neoadjuvant carboplatin/paclitaxel chemotherapy. Neurological examination revealed nystagmus, positive Romberg test, and ataxic gait. Brain and spinal MRI were unremarkable. Differential diagnoses including cerebellar stroke, multiple sclerosis relapse, chemotherapy-induced neurotoxicity, and metabolic encephalopathy were excluded. Although onconeural antibody testing (Anti-Hu, Anti-Yo, Anti-Ri, and Anti-Ma2) was not available, the clinical presentation supported a probable diagnosis of PNS. The patient received high-dose intravenous immunoglobulin (0.4 g/kg/day for 5 days), corticosteroids (methylprednisolone 1 g/day for 5 days), and plasmapheresis, resulting in partial neurological improvement.

Outcome:

Following cytoreductive surgery and continuation of oncologic management, gradual improvement in neurological symptoms was observed over four months, although residual gait impairment persisted.

Conclusion:

PNS should be considered in patients with ovarian cancer presenting with unexplained neurological symptoms despite normal imaging. Early recognition and immunotherapy may improve outcomes.
Keywords
Ovarian Carcinoma
Neoadjuvant
Paraneoplastic
Subjects
Caspian Journal of Surgery

Articles in Press, Accepted Manuscript
Available Online from 08 May 2026