Panegyres and Graves Journal of Medical Case Reports 2012, 6:155 http://www.jmedicalcasereports.com/content/6/1/155 C A S E R E P O R T JOURNAL OF MEDICAL CASE REPORTS Open Access Anti-Yo and anti-glutamic acid decarboxylase antibodies presenting in carcinoma of the uterus with paraneoplastic cerebellar degeneration: a case report Peter K Panegyres1,2* and Angela Graves2 Abstract Introduction: Paraneoplastic cerebellar degeneration is a rare non-metastatic manifestation of malignancy. In this report, to the best of our knowledge we describe for the first time a diagnosis of paraneoplastic cerebellar degeneration several months prior to the diagnosis of clear carcinoma of the uterus. Case presentation: A 75-year-old Caucasian woman manifested a rapidly progressive cerebellar syndrome with nystagmus, past-pointing, dysdiadochokinesis, dysarthria, truncal ataxia and titubation. The paraneoplastic cerebellar degeneration was associated with anti-Yo and anti-glutamic acid decarboxylase antibodies. 14-3-3 protein was detected in the cerebrospinal fluid. She was treated with intravenous immunoglobulin prior to laparotomy, hysterectomy and bilateral salpingoophorectomy. Our patient has survived for three years following diagnosis and treatment. Conclusions: To the best of our knowledge this is the first report of an association of clear cell carcinoma of the uterus and paraneoplastic cerebellar degeneration with both anti-Yo and anti-glutamic acid decarboxylase antibodies. The findings imply that both antibodies contributed to the fulminating paraneoplastic cerebellar degeneration observed in our patient, and this was of such severity it resulted in the release of 14-3-3 protein in the cerebrospinal fluid, a marker of neuronal death. Keywords: 14-3-3 proteins, anti-Yo/anti-GAD antibodies, clear cell carcinoma of uterus, paraneoplastic cerebellar degeneration Introduction Adult onset progressive cerebellar degenerations repre- sent complex diagnostic and management challenges for which genetic and non-genetic causes are recognized. The non-genetic causes are alcohol and toxins, immune mediated, vitamin deficiency, leptomeningeal deposition such as superficial siderosis and chronic infections such as Whipple’s disease [1,2]. Prion disorders and mutations in single genes might also cause sporadic ataxia in adults. * Correspondence: research@ndr.org.au 1Neurodegenerative Disorders Research Pty Ltd, 185 York Street, Subiaco 6009, Western Australia 2Neurology Service, Joondalup Health Campus, Joondalup, Perth, Western Australia Paraneoplastic cerebellar degeneration (PCD) is one of the most important causes of immune-mediated degen- erative cerebellar pathology. This is an uncommon con- dition and can be associated with many different types of tumor, including small cell cancer of the lung, cancer of the breast or ovary and lymphoma [3]. Of the gynecological causes, cancers of the ovary are well recognized. Less appreciated are cancers of the endometrium. In this report, to the best of our know- ledge we describe for the first time the association of clear cell endometrial carcinoma with PCD, anti-Yo, and anti-glutamic acid decarboxylase (GAD) antibodies with detectable protein 14-3-3 in the cerebrospinal fluid (CSF). The diagnosis of PCD led to the diagnosis of endometrial carcinoma. © 2012 Panegyres and Graves; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.