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J Neurol. 2016 May;263(5):1001-1007. doi: 10.1007/s00415-016-8090-7. Epub 2016 Mar 23.

Prostate cancer, Hu antibodies and paraneoplastic neurological syndromes.

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Department of Neurology, Haukeland University Hospital, Bergen, Norway.
Department of Neurology, Haukeland University Hospital, Bergen, Norway.
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Department of Neurology, Ospedale Ca'Foncello, Treviso, Italy.
Service of Neurology, Hospital Clinic, University of Barcelona and Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain.
Department of Neurology, KFJ Hospital, Kundratstraße 3, 1100, Vienna, Austria.
Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
French Reference Center on Paraneoplastic Neurological Syndrome, Department of Neuro-oncology, Hospices Civils de Lyon, Hopital Neurologique, Bron Cedex, France.
Lyon Neuroscience Research Center INSERM U1028/CNRS UMR 5292, Lyon, France.
Universite de Lyon-Universite Claude Barnard Lyon1, Lyon, France.


Prostate cancer is the most common cancer among American and European men. Nervous system affection caused by local tumor growth or osseous metastases are the main causes of neurological symptoms in prostate cancer patients. Prostate cancer is rarely reported in association with paraneoplastic neurological syndromes (PNS). We have, therefore, studied clinical and paraclinical findings of a series of patients with prostate cancer and PNS, and reviewed cases reported in the literature. Case histories of 14 patients with definite PNS from the PNS Euronetwork database and from the authors' databases were reviewed. A PubMed literature search identified 23 patients with prostate cancer and PNS. Thus, a total of 37 case histories were reviewed with respect to syndrome type, cancer evolution, paraclinical investigations, antibody status, treatment and outcome. The three most frequent isolated PNS were paraneoplastic cerebellar degeneration, paraneoplastic encephalomyelitis (PEM)/limbic encephalitis and subacute sensory neuronopathy (SSN). Onconeural antibodies were detected in 23 patients, in most cases the Hu antibody (17 patients, 74 % of all antibody-positive cases). Other well-characterized onconeural antibodies (Yo, CV2/CRMP5, amphiphysin, VGCC antibodies) were found in a minority. PNS was diagnosed prior to prostate cancer diagnosis in 50 % of the cases. The association of PNS with prostate cancer is quite infrequent, but clinically important. PNS often heralds prostate cancer diagnosis. Syndromes associated with Hu antibodies predominate. Another tumor more prone to associate with PNS should always be excluded.


Onconeural antibodies; Paraneoplastic neurological syndrome; Prostate cancer

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