Paraneoplastic limbic encephalitis
In this case, the imaging appearances and presence of a pelvic mass are compelling for the diagnosis of paraneoplastic encephalomyelitis.
CSF
The smear contains scattered lymphocytes, few monocytes and degenerate cells. No malignant cells are identified.
Lymphocytes 35
Monocytes 8
Neutrophils 0
Eosinophils 0
Antibodies and tumor markers
CA-125-New 16 U/mL (normal <35)
CA19.9-New 10 U/ml (normal <37)
Serum/Plasma CEA-New 2.7 ug/L (normal <5.0)
ISLET CELL ANTIBODIES - Serum/Plasma GAD (EIA) <0.6 U/mL (normal <5)
GABA-B Receptor Antibodies: NOT DETECTED
AMPA Receptor Antibodies: NOT DETECTED
NMDA Receptor Antibodies: Not Detected
Anti VGKC Antibody 9 pmol/L (normal <85 )
Anti-Hu (ANNA-1) antibodies POSITIVE.
Anti-Hu antibodies are detected in paraneoplastic peripheral neuropathy or encephalomyelitis, usually in the setting of small cell lung carcinoma, although many other primaries have been described including the ovary 1.