Paraneoplastic Dermatoses Associated With Gynecologic and Breast Malignancies

Levine, Danielle; Миллер, С В; Al-Dawsari, Najla A; Barak, Orr; Gottlieb, Alice B.

doi:10.1097/ogx.0b013e3181efb12a

Cited by 27 publications

(11 citation statements)

References 31 publications

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“…A retrospective study comprising a cohort of 400 DM patients reported the development of malignancy in 15.8% of patients [ 6 ]. Other reports have placed the incidence of DM as a paraneoplastic syndrome in patients with malignancy to be between 6% and 60% [ 7 , 8 ]. The malignancy can occur before, concomitantly, or after the onset of myositis, with a usual peak at two years pre- and post-diagnosis [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Paraneoplastic Dermatomyositis in a Case of Gallbladder Signet Ring Cell Carcinoma

Paul

Mukhopadhyay

Ghosh

et al. 2020

Cureus

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Dermatomyositis (DM), as a paraneoplastic presentation, is rare, though the incidence of malignancies in patients with DM is very high. While it has been reported with a wide range of cancers, association with gallbladder carcinoma is uncommon. Furthermore, signet ring cell carcinoma detected in the metastasis presumably from our patient's gallbladder mass is itself a rare and highly malignant variant of gallbladder adenocarcinoma. Thus, this association can be considered to be a very novel finding. We describe the case of a 64-year-old Indian man who presented with cervical lymph node swelling concurrent with facial rashes, periorbital oedema, nasal regurgitation, dysphagia and weakness in his limbs. The presence of characteristic Gottron’s papules and shawl-like truncal rash on examination led to the diagnosis of DM. Fine needle aspiration cytology (FNAC) of the cervical lymph nodes revealed metastatic signet ring cells, and contrast-enhanced CT (CECT) scan of the abdomen showed a significant gallbladder mass with liver infiltration, thus confirming the underlying association.

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Section: Discussionmentioning

confidence: 99%

Paraneoplastic Dermatomyositis in a Case of Gallbladder Signet Ring Cell Carcinoma

Paul

Mukhopadhyay

Ghosh

et al. 2020

Cureus

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“…Generally, there is no correlation between the severity of clinical symptoms and the size of the primary tumor, and in some cases, paraneoplastic syndromes may manifest before the diagnosis of cancer. [ 7 ] Clinically, about 6 to 60% of cases of malignant tumor are found to be associated closely with dermatomyositis, [ 8 , 9 ] which is often considered as the typical paraneoplastic syndrome. Regarding to myositis-specific anti-p155/140 antibodies have been identified in 50% of cancer-associated myositis cases, significantly higher than in noncancer-associated myositis (4.1%).…”

Section: Discussionmentioning

confidence: 99%

Dermatomyositis as an extrahepatic manifestation of hepatitis B virus-related hepatocellular carcinoma

et al. 2018

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Rationale:Dermatomyositis is an idiopathic inflammatory myopathy with specific cutaneous manifestations, which is closely associated with malignancy. However, the exact mechanism remains elusive. Even less is known about dermatomyositis with hepatocellular carcinoma (HCC).Patient concerns:We reported a case of dermatomyositis with hepatitis B virus (HBV) infection. He incidentally found his lower limbs little weakness accompanied with his wrist erythema. He was found HBsAg positive for forty years with slightly positive of α-fetal protein (AFP).Diagnoses:A dermapathology from his hand-wrist lesions demonstrated a scattered inflammatory infiltrate around the capillaries of the dermis. Abdominal enhanced computer tomography (CT) revealed infiltrative HCC affecting the whole liver, accompanied by liver metastasis and liver cirrhosis. Liver tumor needle biopsy pathology showed HCC with moderate differentiation. The left supraclavicular lymph node needle biopsy pathology confirmed metastasic HCC.Interventions:Prednisolone was gradually withdrawn with the introduction of Entecavir 0.5 mg daily. Radiofrequency ablation therapy for liver tumor was performed once in order to decrease the tumor load.Outcomes:His muscle power improved to grade 4+/5 in the lower limb one month after anti-HBV treatment. However, this patient died finally from liver failure due to the development of liver tumor.Lessons:In the coming clinic work, we must pay more attention to the extrahepatic disorder induced by HBV. On treating experience, glucocorticoid administration is often contraindicated for HBV infected patients because of its potential promotion of HBV replication. Thus, it is necessary to administrate high-effective anti-HBV drug prior to glucocorticoid treatment in order to prevent liver failure.

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“…It is a rare diagnosis, and there is little evidence to guide treatment until now. It is possible to control the evolution of DM with high doses of glucocorticoids associated with immunosuppressive agents and treat cancer with surgery as soon as possible [ 13 , 14 ]. Removal of the cancer induces improvement of paraneoplastic syndrome [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

A rare case of severe myositis as paraneoplastic syndrome on breast cancer

et al. 2015

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BackgroundDermatomyositis and polymyositis are both types of idiopathic inflammatory myositis characterized by inflammation and weakness of proximal skeletal muscles and skin rash.CaseA 49-year-old Caucasian woman recently diagnosed with breast cancer classified as T1N2M0, stage IIIA, presenting skin rash associated with heliotrope and Gottron’s papules. In addition, there was a progression to a severe reduction in proximal muscle strength with severe dysphagia. The initial treatment was conducted, and the patient recovered from all symptoms and followed adjuvant cancer management.TreatmentAt first, high dose of corticosteroid was administered as pulse therapy, and a radical mastectomy was indicated due to the severe symptoms of the paraneoplastic syndrome. Then chemotherapy and radiotherapy were applied, and oral corticoid associated with immunosupressive drug was administered for dermatomyositis control.DiscussionThe association between myositis and an increased risk of cancer has been demonstrated over the years. This patient has a high probability of dermatomyositis diagnosis. The initial treatment with high dose of glucocorticoids may result in an improvement of muscle lesions. Second-line treatment with azathioprine, methotrexate, or cyclophosphamide may be required for aggressive disease. Removal of the cancer induces improvement of paraneoplastic syndrome.ConclusionDermatomyositis can be a clinical manifestation of a paraneoplastic syndrome in patients with breast cancer. It is a rare diagnosis, and there is little evidence to guide treatment until now. It is possible to control the evolution of dermatomyositis with high doses of glucocorticoids in almost all cases; however, in severe cases of paraneoplastic syndrome, cancer treatment should start immediately.

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Paraneoplastic Dermatoses Associated With Gynecologic and Breast Malignancies

Cited by 27 publications

References 31 publications

Paraneoplastic Dermatomyositis in a Case of Gallbladder Signet Ring Cell Carcinoma

Paraneoplastic Dermatomyositis in a Case of Gallbladder Signet Ring Cell Carcinoma

Dermatomyositis as an extrahepatic manifestation of hepatitis B virus-related hepatocellular carcinoma

A rare case of severe myositis as paraneoplastic syndrome on breast cancer

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