A prostate cancer patient in the US developed what researchers called ‘an uncontrollable Irish accent’ during treatment for metastatic disease.
Researchers believe that the foreign accent syndrome heralded transformation to small cell neuroendocrine prostate cancer.
The patient was a male in his 50s with metastatic hormone-sensitive prostate cancer. He was receiving androgen deprivation therapy and abiraterone acetate/prednisone when he presented with an uncontrollable ‘Irish brogue’ accent.
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The patient had no Irish background, consistent with foreign accent syndrome (FAS). Whilst he resided in England in his twenties, and had friends and distant relatives who were Irish, he had never visited Ireland, nor had he ever spoken in an Irish accent previously.
He had no neurological examination abnormalities, psychiatric history or MRI of the brain abnormalities at symptom onset.
Imaging revealed progression of his prostate cancer, despite undetectable prostate-specific antigen levels. A biopsy confirmed transformation to small cell neuroendocrine prostate cancer (NEPC). Despite chemotherapy, his NEPC progressed resulting in multifocal brain metastases and a likely paraneoplastic ascending paralysis leading to his death.
The authors reported FAS as the presenting manifestation of transformation to small cell NEPC, a previously undescribed phenomenon. The patients presentation was most consistent with an underlying paraneoplastic neurological disorder (PND), despite a negative serum paraneoplastic panel.
“His accent was uncontrollable, present in all settings and gradually became persistent,” the report said.
The patient retained the accent until his death.
This is the first recording of a cancer patient developing FAS; two female patients in the UK have developed FAS in recent years, both were stroke victims.
Paper: , et al. Foreign accent syndrome as a heralding manifestation of transformation to small cell neuroendocrine prostate cancer.
