Isolated ZIC4 Antibodies and Autoimmune Encephalitis in a Microsatellite-Instability-High Metastatic Uterine Carcinosarcoma during Immune Checkpoint Inhibitor Treatment

摘要: Paraneoplastic neurological disorders (PNDs) are a group of associated with neoplasm and relatively rare, accounting for less than 1% cancer cases. We present the case 58-year-old woman who was diagnosed metastatic uterine carcinosarcoma received programmed cell death protein-1 inhibitor Pembrolizumab. The patient developed agitation, hallucinations short-term memory loss, followed by seizures progressive unresponsiveness. Intensive care support ventilation were required. Given high suspicion autoimmune encephalitis, paraneoplastic antibody testing requested that strongly positive ZIC4 antibodies solely. unresponsiveness our after immunosuppressive treatment inferred poor prognosis, few days, died. To best knowledge, this is first PND multifocal neurologic deficits in isolated carcinosarcoma. Immunotherapy has been shown to precipitate underlying diseases, leading wide variety symptoms including encephalitis. Our highlights importance evaluating serum/CSF onconeural patients presenting complex determine possibility disorder.