A 63-year old male with a history of alcohol abuse presented with two weeks of confusion and imbalance. On exam, he had left beating nystagmus on left gaze, and right beating and torsional nystagmus on right gaze. Head impulse test was abnormal in all canals bilaterally with video head impulse test showing left horizontal vestibuloocular reflex gain: 0.3, right: 0.4.
Disease/Diagnosis
A pelvic CT scan showed adenopathy in the right pelvis, suspicious for metastatic disease. An MRI pelvis demonstrated stage T3b N1 M0 prostate carcinoma on the right, with possible involvement of the seminal vesicle. Pathologic analysis of biopsy results from the radical prostatectomy and lymph node dissection revealed mixed neuroendocrine carcinoma (75%) and adenocarcinoma (25%). The patient underwent chemotherapy with Etoposide and Cisplatin. T2 MRI signal changes improved transiently. Repeated anti-Hu level was negative three weeks after surgery. The patient did not improve neurologically, and unfortunately passed away about four months after presentation. Final diagnosis: Anti-Hu paraneoplastic process associated with neuro-endocrine tumor of the prostate.
Date
2017-04
References
None.
Language
eng
Format
video/mp4
Type
Image/Moving
Source
49th Annual Frank Walsh Society Meeting
Relation is Part of
NANOS Annual Meeting 2017: Frank B. Walsh Session 2
