Myopathy as paraneoplastic syndrome of colon malignancy in an elderly patient

Dermatomyositis and colorectal cancer: a systematic review

BACKGROUND

Dermatomyositis (DM) is an idiopathic inflammatory myositis. The principal characteristics are cutaneous rash, muscle ache, and muscle weakness. In the past, associations have been established between DM and malignancy, including colorectal cancer.

METHODS

A systematic PubMed and Scopus search was conducted.

RESULTS

The median age of the patients was 65 years (range 40-82). The majority were female (17 out of 27, 63%). Adenocarcinoma was the most frequent histological type of colorectal neoplasm. DM manifested before the diagnosis of colorectal cancer in 21 out of 27 patients (77.8%). At the time of the first presentation, creatine kinase was at a median level of 514.5 U/L (range 50-11,744), and serum antibodies were present in 11 out of 27 patients (40.7%). Immediate improvement of DM symptoms after surgery occurred in 14 out of 26 patients (53.8%). Recurrence of cancer in the form of distal metastasis was present in 5 out of 26 patients (19.2%). Cancer recurrence occurred within a median of 7.9 months (range 2-21) after surgery. In 7 out of 26 patients (26.9%), DM symptoms recurred during the post-operative period. Death was reported in 23 out of 27 patients (85.2%).

CONCLUSION

It is of paramount importance to perform a systematic diagnostic workup for malignancy, always including colonoscopy, in DM patients, since there is a high incidence of cancer in DM patients. Surgical treatment of colorectal tumors should precede the treatment of DM, as DM will frequently regress after a successful resection of malignancy.

Exacerbation of Dermatomyositis with Recurrence of Rectal Cancer: A Case Report

Dermatomyositis (DM) is a rare idiopathic inflammatory myopathy characterized by cutaneous and muscle manifestations. The association between DM and malignancy has been well recognized for many years. The clinical course of paraneoplastic DM may be affected by malignancies, although the cause and effect relationship between exacerbation of DM and cancer progression is uncertain. Herein, we report a 44-year-old woman who presented with progressive DM associated with rectal cancer. After curative resection of rectal cancer, DM symptoms resolved. Three months after surgery, blood test surveillance showed elevation of serum carcinoembryonic antigen levels, although the patient remained asymptomatic. One month later she had a DM flare-up, and multiple lung and liver metastases were found. She immediately underwent cancer chemotherapy with prednisolone therapy for DM. However, her condition deteriorated and she was unable to swallow. Percutaneous endoscopic gastrostomy was constructed, allowing alimentation and oral delivery, which made it possible to keep her on chemotherapy. She had remarkable response for unresectable metastases 8 weeks after the administration of chemotherapy. Seven months after onset of recurrence, her condition improved considerably and she had stable disease. Moreover, she can now eat food of soft consistency. Our case provides further support for the clinical importance of cancer chemotherapy for patients who have progressive DM and unresectable rectal cancer.

Dermatomyositis as an antecedent sign of lung cancer in an eldly patient: a case report

Dermatomyositis (DM) is associated with an increased risk of lung cancer. Misdiagnosed the squamous carcinoma of lung with DM is illustrated by the case who was a 73-year-old male and underwent successful surgical lobectomy presented here. The lack of examination of chest computed tomography (CT) is also emphasized. DM in an adult is a rare clinical entity. To facilitate the preoperative diagnosis and avoid the misdiagnosis of this disease, more etiological factors need to be considered.