A patient with breast cancer and paraneoplastic cerebellar syndrome associated with anti-Purkinje cell antibodies: Response to CMF chemotherapy

A 41-year-old lady underwent a left mastectomy and axillary clearance in 1992, for T2N0 breast cancer. She remained well until December 1995, when she presented with a rapidly progressive cerebellar ataxia. Full investigations for metastatic disease were negative. A clinical diagnosis of paraneoplastic cerebellar degeneration was confirmed by a high titre of anti-Purkinje cell antibodies. She was treated with cyclophosphomide, methotrexate and 5-fluorouracil. The improvement in neurological symptoms was dramatic and has been maintained by further hormone manipulation (ovarian ablation). The patient now leads a normal life without medication.