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Yang H, Chen L. A case of breast cancer with paraneoplastic neurological syndrome as the initial presentation. Asian J Surg 2024:S1015-9584(24)00995-3. [PMID: 38763825 DOI: 10.1016/j.asjsur.2024.05.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 05/10/2024] [Indexed: 05/21/2024] Open
Affiliation(s)
- Huaxiang Yang
- Department of Gastroenterology and Hepatology, Beijing You'an Hospital, Capital Medical University, China; Department of Gastroenterology, the Second People's Hospital of Chengdu, China
| | - Li Chen
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilian University of Munich, Munich, Germany.
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Madala S, Macdougall K, Morvillo G, Guarino R, Sokoloff A. Guillain-Barré Syndrome as a Presenting Symptom in Breast Cancer: The Importance of Considering Paraneoplastic Neurologic Syndrome. Cureus 2021; 13:e17932. [PMID: 34532200 PMCID: PMC8436832 DOI: 10.7759/cureus.17932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 11/17/2022] Open
Abstract
Paraneoplastic neurological syndromes (PNS) are a group of rare immune-mediated disorders with neurological sequela in cancer patients. It usually occurs when an immune response against a systemic tumor is incorrectly directed to the nervous system. Compared to other reported manifestations of PNS in breast cancer, Guillain Barre syndrome (GBS) is exceedingly rare. There is only one other reported case in the literature of GBS that was diagnosed in a breast cancer patient. We report the second recorded case of a 61-year-old female with a history of early-stage breast cancer, who presented with symptoms of lower extremity weakness initially suspected to be GBS but later found to have been recurrent breast cancer. No specific guidelines are available for the treatment of PNS. Treatment of underlying malignancy with chemotherapy and immunotherapies are usually recommended.
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Affiliation(s)
- Samragnyi Madala
- Internal Medicine, Hofstra Northwell School of Medicine, Staten Island, USA
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Severe polymyositis occurring in a cancer patient directly after chemotherapy: etiology and management. Future Sci OA 2021; 7:FSO706. [PMID: 34211735 PMCID: PMC8147826 DOI: 10.2144/fsoa-2021-0011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A 72-year-old woman was diagnosed with metastatic colorectal cancer and treated with oxaliplatin-based chemotherapy and bevacizumab. One week after the second administration of chemotherapy, she presented acute-onset dysphagia and rapidly progressing proximal muscle weakness, associated with elevation of the creatinine phosphokinase enzymes. Magnetic resonance imaging raised suspicion of polymyositis. Etiology remained unclear but paraneoplastic origin or immune modulation by chemotherapy was considered. High-dose methylprednisolone and intravenous immunoglobulins were started with continuation of chemotherapy. Although there was rapid normalization of muscle enzyme, the general status deteriorated rapidly with aggravation of dysphagia, complete immobilization and death. This case highlights the importance of considering muscle weakness as paraneoplastic syndrome or drug-induced toxicity in colorectal cancer patients. Despite aggressive management, prognosis remains poor. During cancer treatment, nonspecific symptoms can occur, such as deglutition trouble and muscle weakness. These symptoms could be related to treatment (drug induced-toxicity) or to cancer (paraneoplastic syndrome). Early recognition of these symptoms is important as they can rapidly increase and impact negatively the outcome of patients. We report the case of a myositis with unclear etiology. Despite aggressive management with intravenous immunoglobulins, the patient died very rapidly.
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Wongsaengsak S, Quirch M, Ball S, Sultan A, Jahan N, Elmassry M, Rehman S. Docetaxel-induced acute myositis: a case report with review of literature. J Chemother 2020; 33:116-121. [PMID: 32619151 DOI: 10.1080/1120009x.2020.1785740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Docetaxel is an anti-microtubule agent and a highly effective treatment of locally advanced and metastatic breast cancer. There are several adverse effects associated with docetaxel, such as myelosuppression, peripheral neuropathy, fluid retention, and asthenia. One of the most well-known side-effects of this medication is mild to moderate myalgia. Here, we report a case of a 49-year-old female with stage 3 breast cancers who developed severe acute myositis following docetaxel use. The mechanism of docetaxel-induced myositis remains unclear; however, physicians still need to be aware of the possibility of this complication in patients with cancer and a history of exposure to this medication.
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Affiliation(s)
- Sariya Wongsaengsak
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Miguel Quirch
- Division of Hematology and Medical Oncology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Somedeb Ball
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Anita Sultan
- Division of Hematology and Medical Oncology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Nusrat Jahan
- Division of Hematology and Medical Oncology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Mohamed Elmassry
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Shabnam Rehman
- Division of Hematology and Medical Oncology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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Fanous I, Dillon P. Paraneoplastic neurological complications of breast cancer. Exp Hematol Oncol 2016; 5:29. [PMID: 27800287 PMCID: PMC5078897 DOI: 10.1186/s40164-016-0058-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 10/14/2016] [Indexed: 12/11/2022] Open
Abstract
Breast cancer is the most frequent cause of cancer of women in much of the world. In countries with screening programs, breast cancer is often detected before clinical symptoms are apparent, but occasionally the occurrence of a paraneoplastic syndrome precedes the identification of cancer. In breast cancer, there are known to be paraneoplastic endocrine syndromes and neurologic syndromes. The neurologic syndromes are often hard to identify and treat. The neurologic syndromes associated with breast cancer include cerebellar degeneration, sensorimotor neuropathy, retinopathy, stiff-persons syndrome, encephalitis, and opsoclonus-myoclonus. Most of these are mediated by antibodies against known neural antigens, although some cases appear to be mediated by non-humoral mechanisms. Treatments differ depending upon the syndrome type and etiology. Outcomes also vary depending upon duration of disease, the treatments used and the responsiveness of the underlying cancer. A thorough review of the published literature is provided along with recommendations for management and future research.
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Affiliation(s)
| | - Patrick Dillon
- University of Virginia, Charlottesville, USA
- UVA Division of Hematology/Oncology, UVA, Box 800716, Charlottesville, VA 22908 USA
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Merali N, Yousuff M, Pronisceva V, Poddar A. Paraneoplastic polymyositis presenting as a clinically occult breast cancer. Ann R Coll Surg Engl 2016; 99:e40-e43. [PMID: 27659377 DOI: 10.1308/rcsann.2016.0301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
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.
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Affiliation(s)
- N Merali
- Queen Elizabeth Queen Mother Hospital, East Kent Hospitals University NHS Foundation Trust , UK
| | - M Yousuff
- Queen Elizabeth Queen Mother Hospital, East Kent Hospitals University NHS Foundation Trust , UK
| | - V Pronisceva
- Queen Elizabeth Queen Mother Hospital, East Kent Hospitals University NHS Foundation Trust , UK
| | - A Poddar
- Queen Elizabeth Queen Mother Hospital, East Kent Hospitals University NHS Foundation Trust , UK
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Croce S, Guèye M, Korganow ACE, Chatelus E, Guèye SMK, Diemunsch P, Mathelin C. Paraneoplastic polymyositis associated with breast cancer: a therapeutic emergency. Breast Cancer Res Treat 2011; 126:811-4. [PMID: 21210207 DOI: 10.1007/s10549-010-1328-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2010] [Accepted: 12/22/2010] [Indexed: 12/11/2022]
Abstract
The association of polymyositis and cancer was first described in 1916, the most frequent cancers being mammary and gynecological for women, bronchopulmonary for men and digestive for both. This article reports a severe paraneoplastic polymyositis associated with breast cancer. The authors discuss its clinical, pathological and therapeutic particularities.
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Affiliation(s)
- S Croce
- Department of Pathology, Hautepierre Hospital, CHRU, Avenue Molière, 67200 Strasbourg Cedex, France
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Paraneoplastic Neurological Syndromes: Unusual Presentations of Cancer. A Practical Review. Am J Med Sci 2010; 340:301-8. [DOI: 10.1097/maj.0b013e3181d9bb3b] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Iavazzo C, Vorgias G, Papadakis M, Manikis P, Mavromatis I, Akrivos T. Polymyositis in a patient with recurring ovarian cancer and history of unrelated breast cancer. Arch Gynecol Obstet 2007; 276:81-4. [PMID: 17219160 DOI: 10.1007/s00404-006-0307-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2006] [Accepted: 12/07/2006] [Indexed: 12/11/2022]
Abstract
BACKGROUND Polymyositis (PM) is an idiopathic inflammatory myopathy. Occasionally, it may present as a paraneoplastic syndrome and it is strongly associated with ovarian and weakly with breast cancer. We present here a case of a 60-year-old patient with sequential breast and ovarian (second primary) carcinomas followed by PM as a paraneoplastic disorder. CASE REPORT The patient had been diagnosed with stage I breast carcinoma 3 years ago and had been treated with conservative surgery followed by radiotherapy and six cycles of chemotherapy (CMF). One and a half year later an ovarian carcinoma was diagnosed for which the patient underwent abdominal hysterectomy oophorectomy and omentectomy. The pathological report characterized it as second primary. Adjuvant chemotherapy with carboplatin and taxol was administered. Fourteen months after the initial laparotomy, the patient was re-operated due to ovarian carcinoma recurrence which was involving all lesser pelvis organs. After a successful radical removal of the recurrence the patient developed a fully expressed PM. This case serves to remind that this disease can occur as a paraneoplastic disorder.
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Affiliation(s)
- C Iavazzo
- Department of Gynecology, METAXA Memorial Cancer Hospital, Piraeus, Greece.
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