Sarcomatoid Malignant Pleural Mesothelioma Associated with Anti-Ma2-related Paraneoplastic Neurological Syndrome: A Case Report

Paraneoplastic neurological syndrome (PNS) is rarely associated with malignant pleural mesothelioma (MPM). We report the first case of sarcomatoid mesothelioma in a 63-year-old female diagnosed with cerebellar degeneration in January 2018. Systemic examination showed right pleura thickening. The pleural biopsy of the mass revealed a sarcomatoid MPM cT3N0M0. In February 2018, anti-Ma2 antibody positivity indicated PNS complicated with MPM. First, cisplatin (75 mg/m2) + pemetrexed (500 mg/m2) chemotherapy was given. For PNS, steroid pulse therapy and high-dose immunoglobulin therapy were administered. MPM may cause anti-Ma2 antibody-related PNS. Early diagnosis and starting anticancer treatment and immunotherapy are critical.