Summary
Although exceedingly rare, the presence of anemia with cerebellar symptoms such as dysdiadochokinesia should trigger a search for a PNS-related malignancy including more rare forms such as peritoneal mesothelioma.
Original Article
Dysdiadochokinesia, Ataxia, and Anemia: A Sign of Intraluminal Malignant Mesothelioma?
ACG Case Reports Journal
Rozner, Raquel MD; Shah, Shawn L. MD; Chiu, Kenrry MDCM; Crawford, Carl V. MD
Abstract
An 87-year-old man presented with altered mental status and ataxia was found to have a neuron-restricted antibody in his cerebrospinal fluid, concerning for a paraneoplastic syndrome of unknown origin. He also exhibited anemia, but otherwise normal electrolytes and liver chemistries. He underwent positron emission tomography/computed tomography which revealed abdominal lymphenopathy. He then underwent push enteroscopy and was found to have a jejunal mass, biopsy proven to be malignant mesothelioma. Malignant mesothelioma is 4–5 times more prevalent in men than women. It is limited to the small bowel, and paraneoplastic syndromes are extremely rare and carry a poor prognosis. The presence of anemia with cerebellar symptoms should trigger a search for a paraneoplastic syndrome-related malignancy.
Disclosures
Authors contributions: R. Rozner, SL Shah, and CV Crawford wrote the manuscript and approved the final manuscript. K. Chiu revised the manuscript for intellectual content and approved the final manuscript. CV Crawford is the article guarantor.
Financial disclosure: None to report.
Previous presentation: This case was presented at the American College of Gastroenterology Annual Scientific Meeting; October 25–30, 2019; San Antonio, Texas.
Informed consent was obtained for this case report.