Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2019; 7(23): 4052-4056
Published online Dec 6, 2019. doi: 10.12998/wjcc.v7.i23.4052
Secondary Parkinson disease caused by breast cancer during pregnancy: A case report
Lei Li
Lei Li, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing 100730, China
Author contributions: Li L designed and performed the research, was in charge of the treatment and follow-up of the patient, and drafted and reviewed the manuscript
Supported by Chinese Academy of Medical Sciences Initiative for Innovative Medicine, No. CAMS-2017-I2M-1-002; National Science-technology Support Plan Projects, No. 2015BAI13B04.
Informed consent statement: Informed written consent was obtained from the patient for publication of this case report and accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Lei Li, MD, Professor, Doctor, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. lileigh@163.com
Telephone: +86-10-69156204 Fax: +86-10-69156204
Received: October 5, 2019
Peer-review started: October 5, 2019
First decision: October 23, 2019
Revised: October 26, 2019
Accepted: October 30, 2019
Article in press: October 30, 2019
Published online: December 6, 2019
Processing time: 62 Days and 10.3 Hours
Abstract
BACKGROUND

Paraneoplastic neurological syndrome manifesting as secondary Parkinson disease caused by breast cancer is extremely rare.

CASE SUMMARY

We report a 39-year-old primipara of 31 gestational weeks, who presented with worsening tremors, facial stiffness and speech disfluencies, and decreased limb strength. Thorough physical examinations and auxiliary tests suggested secondary Parkinson’s disease, but the pathogenesis was unknown. During the cesarean section at the 31 weeks plus 6 d, an exploration and liver biopsy revealed a metastatic, poorly differentiated adenocarcinoma. The positron emission tomography and immunohistochemical analysis confirmed a breast ductal carcinoma of stage IV. To our knowledge, only two reports have documented the association between the breast cancer and the Parkinson disease, and neither occurred in pregnant women.

CONCLUSION

Our case alerts the secondary Parkinson disease as the possible presentation of breast cancer, the most common malignancy during pregnancy.

Keywords: Secondary Parkinson disease; Breast neoplasms; Pregnancy; Case report

Core tip: We described a rare case of severe secondary Parkinson disease which deteriorated during pregnancy. The underlying pathogenesis was confirmed to be breast cancer, which resulted in paraneoplastic neurological syndrome (PNS). Recognition of the variable manifestations of PNS is as important as diagnosis at earlier stages of the underlying malignancy and facilitates prompt treatment to improve prognosis.