A rare case of aquaporin-4-antibody-positive neuromyelitis optica associated with bladder cancer.

BACKGROUND

Paraneoplastic neurological syndrome, a heterogeneous disorder affecting the neurological function, is associated with different types of systemic cancer but rarely with bladder cancer.

CASE REPORT: We report the case of a 54-year-old woman presenting with longitudinally extensive transverse myelitis and optic neuritis (neuromyelitis optica) detected on neurological examination and magnetic resonance imaging of both the brain and spine. As a result, the patient initiated treatment with intravenous steroids for five days. In agreement with the diagnosis, the clinical condition was associated with serum positivity for aquaporin-4 antibodies. Subsequent abdominopelvic computed tomography and biopsy of the mass confirmed urothelial carcinoma, and a radical cystectomy was performed. Immunotherapy was maintained, and the patient showed progressive clinical improvement with total recovery of visual acuity and leg strength three and five months after surgery, respectively. No recurrence was observed during the post-surgery follow-up period of two years.

CONCLUSION

Case reports on paraneoplastic syndrome associated with cancer increases the knowledge on this topic, especially on rare presentations. Our findings further support that early diagnosis of various paraneoplastic symptoms is critical for patient´s treatment and prognosis.