Screening for tumours in paraneoplastic syndromes: report of an EFNS Task Force

• DOI: 10.1111/j.1468-1331.2010.03220.x
• Publication Date: 2010-09-29T04:07:18Z
• Authors: M. J. Titulaer; R. Soffietti; J. Dalmau; N. E. Gilhus; B. Giometto; F. Graus; W. Grisold; J. Honnorat; P. A. E. Sillevis...; R. Tanasescu; C. A. Vedeler; R. Voltz; J. J. G. M. Versc...
• Keywords: Paraneoplastic cerebellar degeneration; Thorax (insect anatomy); Limbic Encephalitis

Background: Paraneoplastic neurological syndromes (PNS) almost invariably predate detection of the malignancy. Screening for tumours is important in PNS as tumour directly affects prognosis and treatment should be performed soon possible. Objectives: An overview screening related to classical given. Small cell lung cancer, thymoma, breast ovarian carcinoma teratoma testicular are described relation paraneoplastic limbic encephalitis, subacute sensory neuronopathy, autonomic neuropathy, cerebellar degeneration, opsoclonus‐myoclonus, Lambert‐Eaton myasthenic syndrome (LEMS), myasthenia gravis peripheral nerve hyperexcitability. Methods: Many studies with class IV evidence were available; one study reached level III evidence. No evidence‐based recommendations grade A–C possible, but good practice points agreed by consensus. Recommendations: The nature antibody, a lesser extent clinical syndrome, determines risk type an underlying For thoracic region, CT‐thorax recommended, which if negative followed fluorodeoxyglucose‐positron emission tomography (FDG‐PET). Breast cancer screened mammography, MRI. pelvic ultrasound (US) investigation first choice CT. Dermatomyositis patients have CT‐thorax/abdomen, US region mammography women, testes men under 50 years colonoscopy women over 50. If primary negative, repeat after 3–6 months screen every 6 up till 4 years. In LEMS, 2 sufficient. where only subgroup malignancy, markers additional value predict probable