Anti-amphiphysin associated paraneoplastic diencephalitis secondary to a thymic neuroendocrine tumour.

The treatment of choice in paraneoplastic syndromes is often to remove any identifiable underlying tumour, though in our case the improvement was unfortunately transient due to incomplete resection of the tumour. 3 Three-week post-operative In-111 octreotide whole-body SPECT scan, showing increased uptake in the anterior mediastinum in keeping with the residual thymic tumour Discussion Anti-amphiphysin paraneoplastic syndromes are rare, most notably associated with breast and lung carcinoma, although have also been described in isolated melanoma cases [[1]]. Our patient presented with characteristic clinical features of diencephalitis, including a narcoleptic syndrome with cataplectic-like attacks (supported by an undetectable CSF orexin), hypothalamic-pituitary endocrine dysfunction, vertical gaze paresis and associated MRI brain abnormalities. [Extracted from the article]