Paraneoplastic motor neuronopathy and malignant acanthosis nigricans

Wladimir Bocca Vieira de Rezende PINTO, Bruno de Mattos Lombardi BADIA, Paulo Victor Sgobbi de SOUZA, Acary Souza Bulle OLIVEIRA, Luiz Henrique Libardi SILVA, Igor Braga FARIAS
2019 Arquivos de Neuro-Psiquiatria  
A 40-year-old woman presented with rapidly progressive quadriparesis and severe weight loss. Examination disclosed global amyotrophy, absent deep tendon reflexes and malignant acanthosis nigricans (Figure) . Neurophysiologic studies disclosed pure motor neuronopathy. Paraneoplastic screening with fullbody CT/MRI scan revealed an intravesical mural lesion ( Figure) and urethrocystoscopy showed low-grade papillary urothelial carcinoma of the urinary bladder. High-titer serum anti-Hu antibodies
more » ... e identified. There was marked motor and dermatological improvement after lesion removal, combined with intravenous immunoglobulin and methylprednisolone. Dermatological signs are key diagnostic clues in the suspicion of underlying malignancies 1 , including rarely urological malignancies 2 , in the context of paraneoplastic motor neuronopathy 3,4 .
doi:10.1590/0004-282x20190076 pmid:31365646 fatcat:etjeik7tl5hmtljtrjvvjqt3d4