Paraneoplastic necrotizing myopathy – a case report

Abstract

RBRE-119; No. of Pages 4 r e v b r a s r e u m a t o l . 2 0 1 4;x x x(x x):xxx-xxx REVISTA BRASILEIRA DE REUMATOLOGIA w w w . r e u m a t o l o g i a . c o m . b r a b s t r a c t Immune-mediated necrotizing myopathy is a rare and recently described form of idiopathic inflammatory myopathy, frequently misunderstood with polymyositis. Minimal or no inflammatory infiltrate on muscle biopsy is one of the most distinctive features. Gastrointestinal, lung and breast neoplasms are the most common oncologic related causes, but they may occur in patients with others malignancies. This case is the first reported in Brazil and the first associated with neoplasia in Latin America, and highlights the need for clinical suspicion of cancer in patients with idiopathic inflammatory myopathies.Palavras-chave: Miopatias inflamatórias Síndromes paraneoplásicas Neoplasia de ovário r e s u m o A miopatia necrosante imunomediada é forma rara e recentemente descrita de miopatia inflamatória idiopática, frequentemente confundida com polimiosite. Uma das caracterís-ticas mais distintivas é a presença de infiltrado inflamatório mínimo ou a ausência de tal infiltrado à biópsia do músculo. As causas oncológicas relacionadas mais comuns são neoplasias gastrointestinais, do pulmão e de mama, mas pode ocorrer em pacientes com outras doenças malignas. Este caso é o primeiro publicado no Brasil e o primeiro associado à neoplasia na América Latina, destacando a necessidade de suspeita clínica de câncer em pacientes com miopatias inflamatórias idiopáticas.

Necrotizing myopathy as paraneoplastic disorder in tonsillar squamous cell carcinoma

“…In our case, patient was not on statins and was recently diagnosed with squamous cell carcinoma of tonsil. Necrotizing myopathy is relatively uncommon with only a handful of reports in the literature [12][13]. About 50% of patients with polymyositis or dermatomyositis have myositis specific antibodies [5][6].…”

“…There are a few published reports on dermatomyositis associated with small cell carcinoma and adenocarcinoma of the lung, gastrointestinal, breast carcinoma, and ovarian and nasopharyngeal and squamous cell carcinoma of tonsil [5][6][7][8][9][10][11]. There are limited reports on paraneoplastic necrotizing myopathy [12][13], none in relation to squamous cell carcinoma of tonsil. We report an unusual case of necrotizing myopathy with negative myositis specific antibodies in a patient with recent diagnosis of squamous cell carcinoma of tonsil.…”