Ballistic-choreic movements as the presenting feature of renal cancer. Arch Neurol 2001 Jul;58(7):1133-5
Date
08/02/2001Pubmed ID
11448303DOI
10.1001/archneur.58.7.1133Scopus ID
2-s2.0-0034937805 (requires institutional sign-in at Scopus site) 39 CitationsAbstract
BACKGROUND: The paraneoplastic syndromes can involve multiple areas of the central nervous system and result in a variety of neurological symptoms. To our knowledge, severe, rapidly progressive, and drug-resistant ballistic-choreic movements have not been previously described as the presenting feature of renal cell carcinoma.
PATIENT AND METHODS: A previously healthy 55-year-old man developed limb ballismus and involuntary choreic movements of his face over several weeks. Extensive laboratory, diagnostic, and radiographic studies failed to reveal a cause, until an abnormality on a chest x-ray film prompted a search for a primary neoplasm and a final diagnosis of renal cell carcinoma. High doses of medications traditionally used to treat choreic disorders had no effect on the abnormal movements. A biopsy specimen of the basal ganglia showed focal encephalitic changes but no malignant neoplasm.
CONCLUSIONS: Whereas prior cases of paraneoplastic syndromes with chorea have been reported in other forms of cancer, our case was significant because, to our knowledge, renal cell carcinoma has not been previously reported in association with this syndrome. Furthermore, the chorea was categorically resistant to pharmacological treatment, and the movement disorder was the initial and only focal neurological feature of the primary illness.
Author List
Kujawa KA, Niemi VR, Tomasi MA, Mayer NW, Cochran E, Goetz CGAuthors
Elizabeth J. Cochran MD Adjunct Professor in the Pathology department at Medical College of WisconsinKathy Kujawa MD Associate Professor in the Neurology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Basal GangliaBiopsy
Carcinoma, Renal Cell
Chorea
Diagnosis, Differential
Dyskinesias
Humans
Kidney Neoplasms
Male
Middle Aged
Paraneoplastic Syndromes
