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Abstract
The simultaneous involvement of different areas of the nervous system by the paraneoplastic process is not unusual. [...]date, this is the first report of concurrent development of paraneoplastic cerebellar degeneration (PCD) and paraneoplastic limbic encephalitis (PLE) associated with the advanced ovarian cancer and anti-Yo antibodies following hepatitis B (HB) vaccination. Few days later, the patient developed rapidly progressive ataxia, involuntary movements of arms, slurred speech, anxiety, depression, agitation, irritability, aggressive behavior, dysarthria, dysphagia, choking while drinking, hypomnesia, and sleeping disturbance. Both ultrasonography and computed tomography (CT) showed bilateral adnexal cystic-solid masses and several enlarged retroperitoneal lymph nodes [Figure 1]a and [Figure 1]b.{Figure 1} Exploratory laparoscopy [Figure 1]c and biopsy indicated pelvic disseminated malignant lesions. [...]the patient was only treated with two cycles of the same regimen chemotherapy, and her family gave up the following treatment due to the serious adverse effects of chemotherapy. [...]date, she has been alive for 38 months without any recurrent evidence. The triggering mechanism of autoimmune disease after a vaccination might be classified as an antigen-specific or an antigen nonspecific process in which the vaccination induces cytokines and aberrant expression of major histo-compatibility complex class II and further facilitates autoantigen expression and autoreactive T-cell activation that precipitates into a cascade of self-propagating autoimmunity. Recent literatures have reported that the patients without antibodies have a better response to treatment compared to patients with antibodies. [...]laboratory assessment for these onco-neural antibodies not only serves as a diagnostic modality but also aids in predicting prognosis. [...]management of the primary...