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. 2023 Jan;270(1):283-299.
doi: 10.1007/s00415-022-11356-9. Epub 2022 Sep 1.

Paraneoplastic neurological syndromes associated with renal or bladder cancer: case series and PRISMA-IPD systematic review

Macarena Villagrán-García  1   2 , Sergio Muñiz-Castrillo  1   2 , Nicolás Lundahl Ciano-Petersen  1   2   3   4 , Alberto Vogrig  5 , Antonio Farina  1   2 , Marine Villard  1 , Dimitri Psimaras  6   7 , Agusti Alentorn  6   7 , David Gonçalves  8 , Nicole Fabien  8 , Véronique Rogemond  1 , Bastien Joubert  1   2 , Jérôme Honnorat  9   10
Affiliations

Paraneoplastic neurological syndromes associated with renal or bladder cancer: case series and PRISMA-IPD systematic review

Macarena Villagrán-García et al. J Neurol. 2023 Jan.

Abstract

Background: The link between paraneoplastic neurological syndromes (PNS) and renal cell and bladder cancer (RCC/BC) is rare and uncertain. Our aim was to clinically evaluate, in light of the updated PNS criteria, these uncommon associations.

Methods: Retrospective nationwide cohort chart review study and systematic review of the literature.

Results: After excluding 5 patients due to the diagnosis of another co-occurrent malignancy, 10/18 patients with RCC and 8/18 patients with BC were identified. A total of 31 cases were previously published, yielding an overall series of 27/49 RCC and 22/49 BC patients. There was a predominance of cerebellar syndromes in both cancers (10/27, 37% for RCC; 9/22, 41% for BC), followed by encephalitis in 9/27 (33%) patients with RCC and encephalomyelitis/sensory neuronopathy in 5/22 (23%) patients with BC. The detection of high-risk Abs was more frequent among BC patients (16/19, 84% vs. 3/13, 23% in RCC, p = 0.0009), Ri antibodies being the most frequent thereof. After applying the updated PNS criteria, patients with BC met highest degrees (possible, probable, and definite) of certainty for PNS diagnosis (20/22, 91% vs. 16/27, 59% in RCC, p = 0.021).

Conclusion: A second neoplasm should always be ruled out before establishing the diagnosis of PNS in patients with RCC or BC. However, while this association remains dubious for most patients with RCC, a casual role is more probable in patients with BC and high-risk antibodies presenting with cerebellar ataxia, brainstem encephalitis or encephalomyelitis/sensory neuronopathy.

Keywords: Bladder cancer; Cerebellar ataxia; Neural antibodies; Paraneoplastic neurological syndromes; Renal cell cancer.

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References

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