Two Paraneoplastic Syndromes in a Patient with Ovarian Cancer: Nephrotic Syndrome and Paraneoplastic Cerebellar Degeneration

Background. A paraneoplastic syndrome—a rare, indirect system disturbance located distant from a neoplasm—has been reported in association with ovarian cancer. Case. Two paraneoplastic syndromes—nephrotic syndrome and paraneoplastic cerebellar degeneration (PCD)—developed in a patient who had no symptoms from ovarian cancer. She presented with the nephrotic syndrome. Evaluation for metastasis, including computed tomography (CT) scan and ultrasonography, showed a slightly enlarged right ovary and a 2-cm lower paraaortic lymph node on the right side. A 5-cm ovarian mass and multiple paraaortic lymph nodes were excised, and six cycles of carboplatin and paclitaxel were given. Nephrotic syndrome symptoms had greatly subsided at 6 weeks after surgery. At 7 months after surgery, symptoms of PCD developed yet CT, CA-125 levels, and physical examination showed no evidence of ovarian cancer. Conclusion. To our knowledge, development of two paraneoplastic syndromes in one patient with ovarian cancer has not been reported. Nephrotic syndrome resolved with treatment of the neoplasm whereas PCD did not.