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Paraneoplastic Syndrome — RACP Adult Medicine MCQ

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HardMedical OncologyParaneoplastic SyndromeRACP Adult Medicine

A 60-year-old man presents with a 6-month history of progressive cerebellar ataxia and peripheral neuropathy. He has anti-Yo antibodies in his serum. CT chest/abdomen/pelvis reveals a lung mass. What is the underlying syndrome?

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Correct answer: D — Paraneoplastic cerebellar degeneration

Anti-Yo (anti-Purkinje cell) antibodies are associated with paraneoplastic cerebellar degeneration, most commonly seen with ovarian and breast cancers in women and lung cancer in men. The cerebellar syndrome often precedes cancer diagnosis. Treatment of the underlying malignancy may stabilise but rarely reverses the neurological deficit. Immunotherapy (IVIg, corticosteroids, rituximab) has limited efficacy once neuronal damage is established.

Reference: eTG – 2025 – Neurology; Graus et al – 2004 – Paraneoplastic Neurological Syndromes