Dermatomyositis as presenting feature of ovarian cancer, treated with neo-adjuvant chemotherapy and interval debulking surgery

Christie, Alan; McKay, Neil; Nussey, Fiona

doi:10.1016/j.gynor.2013.07.002

Cited by 11 publications

(12 citation statements)

References 8 publications

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“…Few studies reported recurring cases of DM and other cancers. These reports demonstrated the association between DM symptoms and cancer recurrence in patients with ovarian cancer [15], breast cancer [16], and bladder cancer [17], supporting our findings in colorectal cancer. The present report describes a rare case with a good outcome of resecting liver metastases that were detected early by exacerbation of skin symptoms before annual examination in a patient with DM accompanied by rectal cancer.…”

Section: Discussionsupporting

confidence: 88%

Successful resection of liver metastasis detected by exacerbation of skin symptom in a patient with dermatomyositis accompanied by rectal cancer: a case report and literature review

et al. 2017

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BackgroundDermatomyositis (DM) is a rare syndrome that belongs to the group of idiopathic inflammatory myopathies. The association between DM and malignancy is well recognized, and the severity of DM symptoms has been linked to the progression of metastatic disease.Case presentationWe report the case of a 42-year-old man that was diagnosed with dermatomyositis (DM) and rectal cancer. Proctectomy was performed, and DM symptoms were resolved postoperatively. One year and 9 months after the surgery, liver metastasis occurred accompanied by the exacerbation of DM symptom. Partial resection of the liver was performed, and postoperative course was uneventful. DM symptoms improved postoperatively, and no evidence of cancer recurrence or DM symptoms was observed 2 years after the second surgery. To date, few reports have described recurring cases of DM accompanied by colorectal cancer in detail. We reviewed four similar cases that were reported poor prognoses with treatment resistance. However, our case report demonstrates good long-term results with resection of metastatic lesion.ConclusionsIt is important to check the exacerbation of DM symptoms, as this symptom sometimes preceded cancer relapse during the follow-up of our patient with DM and colorectal cancer.

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Section: Discussionsupporting

confidence: 88%

Successful resection of liver metastasis detected by exacerbation of skin symptom in a patient with dermatomyositis accompanied by rectal cancer: a case report and literature review

et al. 2017

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“…25 Some research supports the idea that successful cancer treatment can lead to remission of the myositis. 27,28 However, the literature also provides evidence of cases where a cancer is cured but the autoimmune myositis continues and requires long-term immunosuppression. 29,30 There is an unproven theory that autoimmune myositis is a product of molecular mimicry and a successful immune response to a malignancy.…”

Section: Discussionmentioning

confidence: 99%

“…Respondent feedback revealed the following themes on the subject of non-conduct of malignancy screening: (i) an absence of high-quality literature to support the practice, (ii) professional experience of a lack of clinical utility of the practice and (iii) suspected literature bias (Table 3). • 'A good history will lead to specific screening rather than submit every patient to a standard battery of tests in a shotgun approach' [28] • 'Increasingly I am now doing PET scans as usual screening has missed malignancy subsequently found on PET' [11] • 'Highly variable depending on History / Examination / Age / Ethnicity and disease features' [20] Theme: Triggers for initial screening • 'Especially NXP2' [55] • 'Only if response to treatment tapering is poor' [47] • 'When patients present with specific antibodies screening is not required.' [40] • '…Screening in inclusion body myositis is also favoured…' [35] Themes: Triggers for repeat screening • '…subtypes more commonly associated with malignancy eg Tif1… would guide me to be more proactive… if initial screening tests are negative' [52] • 'This is often risk driven / therapy driven and patient recovery status' [5] • 'The patient is often under regular review, any focal symptoms are followed up without delay' [30] • 'I will rescreen if there are warning bells' [12] • 'I would consider repeat screening if unexpected relapse' [11] Theme: Approach to repeat screening • '…little or no evidence to support present practice of repeated tests.…”

Section: Cancer Screening Rates Confidence Screening Allocation Andmentioning

confidence: 99%

Malignancy screening in autoimmune myositis among Australian rheumatologists

Dutton

Soden

2017

Internal Medicine Journal

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“…4 The reported incidence for inflammatory myositis varies from 0.5 to 0.89 per 100,000 per year. 5 We report a rare case of metaplastic breast carcinoma with an unusual presentation of paraneoplastic polymyositis.…”

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confidence: 95%

Paraneoplastic polymyositis presenting as a clinically occult breast cancer

Merali

Yousuff

Pronisceva

et al. 2017

annals

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Paraneoplastic syndrome affects less than 1% of cancer patients. Diagnosis of paraneoplastic syndrome with neurological presentation requires screening for an underlying malignancy, including a complete history, physical examination and imaging studies. Treatment often results in symptom stability, rather than improvement. Paraneoplastic polymyositis can precede or instantaneously occur at diagnosis or treatment of a primary tumour, while neurological symptoms can persist even following cancer treatment. We report a rare case of metaplastic breast carcinoma with an unusual presentation of paraneoplastic polymyositis. KEYWORDSParaneoplastic syndrome -Metaplastic carcinoma -Diagnosis -Neurology -Breast cancer Paraneoplastic syndrome is a rare condition, affecting less than 1% of cancer patients.1 Diagnosis of paraneoplastic syndrome with neurological presentation requires screening for an underlying malignancy. This process includes a complete history, physical examination and imaging studies. 1Treatment often results in symptom stability, rather than improvement.1 Paraneoplastic polymyositis can precede or instantaneously occur at diagnosis or treatment of a primary tumour. Neurological symptoms can persist even following cancer treatment.2 Polymyositis belongs to a heterogeneous group of autoimmune diseases called inflammatory myopathies, which are characterised by proximal skeletal muscle weakness, cutaneous manifestations, elevated serum creatine kinase activity and inflammatory cells in muscle biopsy. Polymyositis is a cell-mediated autoimmune disorder. 3 The first reported association between malignancy and myositis was made by Stertz G et al in 1916. 4 The reported incidence for inflammatory myositis varies from 0.5 to 0.89 per 100,000 per year. 5We report a rare case of metaplastic breast carcinoma with an unusual presentation of paraneoplastic polymyositis. Case presentationA 66-year-old caucasian female presented with progressive difficulties with walking and climbing stairs, and developed proximal muscle weakness, paresthesia and gait ataxia over a period of 11 months. She became wheelchair-dependent and required hospital admission under the care of a neurologist. The patient had no relevant past medical history.Cerebrospinal fluid oligoclonal bands were negative, and a raised creatine kinase (CPK) level of 825 IU/L was detected on admission. Autoantibodies directed against antiRo, anti-Jo and anti-La, and extractable nuclear antigen antibodies, were detected. The antinuclear antibody test was positive. Electromyography was consistent with myopathy. An open-muscle biopsy of the leg revealed endomysial mononuclear cells and myonecrosis indicative of inflammatory myopathy.Patient was referred for radiological investigations. Computed tomography of the chest, abdomen and pelvis was unremarkable. Magnetic resonance imaging of the lower limbs showed inflammatory changes consistent with myositis and myopathy. As part of the investigations for the neurological presentation of paraneoplastic syndrome wi...

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Dermatomyositis as presenting feature of ovarian cancer, treated with neo-adjuvant chemotherapy and interval debulking surgery

Cited by 11 publications

References 8 publications

Successful resection of liver metastasis detected by exacerbation of skin symptom in a patient with dermatomyositis accompanied by rectal cancer: a case report and literature review

Successful resection of liver metastasis detected by exacerbation of skin symptom in a patient with dermatomyositis accompanied by rectal cancer: a case report and literature review

Malignancy screening in autoimmune myositis among Australian rheumatologists

Paraneoplastic polymyositis presenting as a clinically occult breast cancer

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