Squamous cell carcinoma masquerading as focal myositis of the tongue

Left gluteal focal myositis in a patient with signet ring adenocarcinoma of the stomach: not a paraneoplastic phenomenon

Focal myositis, the much rarer clinical and pathological variant of polymyositis, is generally a benign inflammatory pseudotumor of skeletal muscle Thus far, only three cases have been reported in association with a neoplasm. We now describe a fourth case of localized gluteal myositis seen in a case of signet ring adenocarcinoma of the stomach occurring not as a paraneoplastic syndrome, as in the previously reported three cases, but as an immunoinflammatory response around metastatic cell foci in both the involved muscles and local lymphatics.

Symptomatic macroglossia and tongue myositis in polymyositis: treatment with corticosteroids and intravenous immunoglobulin

Symptomatic macroglossia occurs in some rare congenital muscle diseases, such as Becker's and Duchenne's dystrophies or Pompe's disease. Herein we describe a case of symptomatic macroglossia with myositis of the tongue occurring in a patient with polymyositis. Tongue myositis was evidenced by dysarthria, frequent biting during mastication, swallowing difficulties without aspiration, and noisy breathing. Magnetic resonance imaging showed homogeneous hypertrophy of the tongue, especially the mouth's floor muscles. The diagnosis of tongue myositis was established by electromyography and biopsy. No other cause for the macroglossia was found. Symptoms resolved quickly with corticosteroid and intravenous immunoglobulin treatment. To our knowledge, this is the first reported case of symptomatic tongue myositis occurring in the course of polymyositis.

Sclerosing inflammatory myofibroblastic tumour of the tongue: an immunohistochemical and ultrastructural study

A case of inflammatory myofibroblastic tumour (IMT) arising in the tongue of a 27-year-old man is described. The patient presented with a solitary, well-circumscribed submucosal mass of 4 months duration. The tumour showed in its largest part a paucicellular sclerosing lesion resembling a hyalinizing granuloma surrounded by a thin rim of an admixture of myofibroblasts, plasma cells and foamy histiocytes. Myofibroblasts expressed vimentin and alpha-smooth muscle actin positive immunophenotypes. Ultrastructurally the hyaline areas were composed of abundant collagen fibres with sparse myofibroblasts. Extensive scar-like change in this IMT may be related to a traumatic insult.

Cancer-associated rheumatic disorders: clues to occult neoplasia

Interest in the rheumatologic manifestations of cancer is related in part to practical considerations, ie, earlier cancer diagnosis is possible through enhanced awareness of cancer-associated rheumatic syndromes. The spectrum of rheumatic disorders associated with cancer includes over 30 conditions, including hypertrophic osteoarthropathy, polymyalgia rheumatica, palmar fasciitis with polyarthritis, most autoimmune connective tissue diseases, and the more recently described antiphospholipid syndrome. It is generally held that extensive search for occult malignancy in most rheumatologic disorders is not cost efficient and not recommended unless accompanied by specific findings suggestive of malignancy. The present article discusses the supplementary findings that may justify malignancy evaluation.

Localized nodular myositis. A paraneoplastic phenomenon

Localized nodular myositis was recognized in an elderly man six months prior to the diagnosis of Hodgkin's disease. Meticulous search of the muscle specimen failed to disclose tumorous involvement. The possible paraneoplastic nature of localized nodular myositis in this patient is discussed.