Paraneoplastic encephalitis (PE) represents a rare but significant complication in patients with testicular cancer (TC). Given the paucity of comprehensive literature on this topic, our review seeks to consolidate current knowledge and provide evidence-based recommendations for the diagnosis, prognosis, and management of PE in the context of TC.
In adherence to PRISMA guidelines, a systematic literature review was conducted from 1950 to April 2024 using PubMed. The search focused on articles where TC was identified as the primary etiology of PE. The Mixed Methods Appraisal Tool and the Oxford Centre for Evidence-Based Medicine's levels of evidence tool were employed for assessing study quality, and a thematic analysis was conducted to identify trends and patterns.
Out of 91 articles identified, 29 met the inclusion criteria, encompassing 5 retrospective chart reviews, 3 case series, and 22 case reports. Findings indicate that PE symptoms can manifest at any stage of TC-before tumor detection, during treatment, or even years posttreatment. A notable observation was the frequent oversight of microscopic testicular tumors in ultrasound imaging, leading to diagnostic delays. The outcomes of PE in the context of TC were diverse, reflecting the heterogeneity of the studies included.
PE, although rare, is a critical consideration in patients with TC presenting with neuropsychiatric symptoms. Early recognition and appropriate diagnostic workup, including consideration for microscopic neoplasms, are essential for timely intervention and improved patient outcomes.
Clinical genitourinary cancer. 2024 May 01 [Epub ahead of print]
Ekamjit Singh Deol, Awais Paracha, Maria Paracha, Omar Moussa Pasha, Esed Mustafic, Regan Davis, Zohair Siddiqui, Ali Abid, Umar Durrani, Wilson Rodriguez, Xinhua Zhu, Zachary Hamilton
Division of Hematology and Medical Oncology, Department of Internal Medicine, Saint Louis University School of Medicine, Saint Louis, MO. Electronic address: ., Division of Hematology and Medical Oncology, Department of Internal Medicine, Saint Louis University School of Medicine, Saint Louis, MO., Department of Biology, University of Virginia, Charlottesville, VA., Department of Biology, Saint Louis University, Saint Louis, MO., Department of Neurology and Psychiatry, Saint Louis University School of Medicine, St. Louis, MO., Division of Medical Oncology & Hematology, Northwell Health Cancer Institute, Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Lake Success, NY., Division of Urology, Department of Surgery, Saint Louis University School of Medicine, Saint Louis, MO.