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Royal-Preyra B, Boucher M, Marsan I. Urticaria Heralding Breast Cancer: Case Report and Literature Review. Adv Radiat Oncol 2024; 9:101433. [PMID: 38435967 PMCID: PMC10906169 DOI: 10.1016/j.adro.2023.101433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/15/2023] [Indexed: 03/05/2024] Open
Affiliation(s)
- Benjamin Royal-Preyra
- Department of Radiation Oncology, Regional University Affiliated Hospital Centre of Trois-RIvieres, University of Montreal, Montreal, Canada
| | - Melanie Boucher
- Department of Radiation Oncology, Regional University Affiliated Hospital Centre of Trois-RIvieres, University of Montreal, Montreal, Canada
| | - Isabelle Marsan
- Department of Radiation Oncology, Regional University Affiliated Hospital Centre of Trois-RIvieres, University of Montreal, Montreal, Canada
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Sabaté-Ortega J, Bujons-Buscarons E, Fina-Planas C, Vilanova-Anducas N, Vidal-Sarró N, Sala-González N. Paraneoplastic dermatomyositis associated with urothelial cancer: report of a case and systematic review of the literature. Front Oncol 2023; 13:1223627. [PMID: 38023222 PMCID: PMC10644711 DOI: 10.3389/fonc.2023.1223627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
Background The idiopathic inflammatory myopathies (IIM) are a collection of autoimmune diseases that have a substantial impact on the entire body and include conditions such as dermatomyositis (DM), polymyositis (PM), sporadic inclusion body myositis, and immune-mediated necrotizing myopathy. These disorders are characterized by symptoms such as muscular weakness, pain, and dermal rash. This systematic review is intended to explore the potential link between bladder cancer and DM/PM. Methods We performed a comprehensive systematic search on PubMed and Scopus until August 2022 to identify relevant research studies. The studies that met our inclusion criteria focused on patients with urinary bladder cancer and dermatomyositis, and/or polymyositis. Results The patients' median age was 65.5 years (47-79), with the majority being male (15, 39.47%). Bladder cancer manifested before PM/DM in 5 (13.15%) patients, while in the majority of cases occurred after the cancer diagnosis. The stage of cancer at the time of the initial PM/DM diagnosis were mostly locally (11/20, 50%).During the first presentation, the patients had a median creatine kinase level of 2227 U/L, ranging between 44 and 10471. In one case, anti-TIF-1γ antibodies were found to be present. Among the cases with reported medical history (20/38), treatment immediately improved DM symptoms in 16 patients(53.8%) and in 3 patients(15%), symptoms of DM resurfaced during the period after the operation. Death was reported in 14 (36.8%) patients. Conclusion In conclusion, our study provides knowledge and understanding for identifying specific risk factors in patients with the coexistence of bladder cancer and DM/PM and their management. During the initial and follow-up screening, age, gender, and the clinicopathological subgroup of myositis should be considered to ensure proper management of the condition.
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Affiliation(s)
- Josep Sabaté-Ortega
- Oncology Department, Catalan Institute of Oncology, Hospital Universitari Dr. Josep Trueta, Girona, Spain
| | - Elisabet Bujons-Buscarons
- Oncology Department, Catalan Institute of Oncology, Hospital Universitari Dr. Josep Trueta, Girona, Spain
| | - Clàudia Fina-Planas
- Oncology Department, Catalan Institute of Oncology, Hospital Universitari Dr. Josep Trueta, Girona, Spain
| | | | - Noemí Vidal-Sarró
- Department of Pathology, Hospital Universitari de Bellvitge.L’Hospitalet, Barcelona, Spain
| | - Núria Sala-González
- Oncology Department, Catalan Institute of Oncology, Hospital Universitari Dr. Josep Trueta, Girona, Spain
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Paul A, Mukhopadhyay A, Ghosh SK, Samanta K, Das S. Paraneoplastic Dermatomyositis in a Case of Gallbladder Signet Ring Cell Carcinoma. Cureus 2020; 12:e10730. [PMID: 33145135 PMCID: PMC7599053 DOI: 10.7759/cureus.10730] [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] [Indexed: 11/05/2022] Open
Abstract
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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Affiliation(s)
- Aritra Paul
- Department of Surgery, Nil Ratan Sircar Medical College and Hospital, Kolkata, IND
| | | | - Sudip Kumar Ghosh
- Department of Dermatology, R. G. Kar Medical College and Hospital, Kolkata, IND
| | - Kaustav Samanta
- Department of Surgery, R. G. Kar Medical College and Hospital, Kolkata, IND
| | - Subhabrata Das
- Department of Surgery, R. G. Kar Medical College and Hospital, Kolkata, IND
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Gualtieri B, Hertl M. Tumorerkrankungen an der Haut erkennen – paraneoplastische Hauterkrankungen. Internist (Berl) 2020; 61:860-868. [DOI: 10.1007/s00108-020-00831-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Wollina U, Hansel G, Lotti T, Tchernev G, Vojvodic A, Temelkova I. Acanthosis Nigricans - A Two-Sided Coin: Consider Metabolic Syndrome and Malignancies! Open Access Maced J Med Sci 2019; 7:3081-3084. [PMID: 31850127 PMCID: PMC6910804 DOI: 10.3889/oamjms.2019.258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/04/2019] [Accepted: 05/05/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Acanthosis nigricans (AN) is acquired hyperpigmentation of the intertriginous body regions. Histologically, AN is characterised by a thickened stratum corneum and a variable amount of acanthosis. Although benign and rarely symptomatic, AN may be a red flag for underlying pathologies. CASE PRESENTATION We analysed our patients with AN and could differentiate three different patterns, that are illustrated by one case report each. The is the benign AN associated with metabolic syndrome including obesity. The second type is the paraneoplastic AN malignancy which is associated with a wider range of malignancies. This type may occur before, after or with the clinical appearance of the malignancy. The third type is relapsing AN after complete remission. We present a patient who had a malignant AN and was treated successfully for his cancer. Years later, however, AN relapsed. In that case in association with the appearance of skin tags. Cancer restaging excluded a tumour relapse. His BMI was 31.2 kg/m2, and the diagnosis of benign AN was confirmed. CONCLUSIONS The diagnosis of AN remains incomplete without screening for metabolic syndrome and/ or cancer. The combination of AN and skin tags is more often associated with metabolic syndrome. AN may be considered as a red flag for malignancies and the metabolic syndrome.
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Affiliation(s)
- Uwe Wollina
- Department of Dermatology and Allergology, Teaching Hospital Dresden - Friedrichstadt, Dresden, Germany
| | - Gesina Hansel
- Department of Dermatology and Allergology, Teaching Hospital Dresden - Friedrichstadt, Dresden, Germany
| | - Torello Lotti
- Professor & Chair of Dermatology, University of Rome "G. Marconi", Rome , Italy
| | - Georgi Tchernev
- Onkoderma - Clinic for Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606, Sofia, Bulgaria
| | - Aleksandra Vojvodic
- Department of Dermatology and Venereology, Military Medical Academy of Belgrade, Belgrade, Serbia
| | - Ivanka Temelkova
- Onkoderma - Clinic for Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606, Sofia, Bulgaria
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Abstract
A variety of cutaneous abnormalities can be seen in patients with malignant diseases, some of which are infectious, with others representing direct involvement of the skin by the underlying disorder. Yet another group of lesions can be regarded as associated markers of the malignant process, and, as such, are termed "paraneoplastic." This review considers the latter collection of conditions, grouping them by the generic type of malignancy that is usually linked to the paraneoplasia. Some of the processes show a predominant association with alimentary tract malignancies (acanthosis nigricans, acrodermatitis paraneoplastica, florid cutaneous papillomatosis, necrolytic migratory erythema, palmoplantar keratoderma, pancreatic fat necrosis, and pityriasis rotunda). Others are usually linked to a hematolymphoid malignancy (acquired ichthyosis, exfoliative erythroderma, necrobiotic xanthogranuloma, pemphigus paraneoplastica, plane xanthoma, pyoderma gangrenosum, scleromyxedema, Sweet syndrome, and leukocytoclastic vasculitis). Finally, yet another collection of paraneoplastic skin disorders can associate themselves with anatomically-diverse malignancies (Leser-Trelat syndrome, Trousseau syndrome, dermatomyositis, erythema gyratum repens, hypertrichosis lanuginosa acquisita, papuloerythroderma of Ofuji, tripe palms, and multicentric reticulohistiocytosis). Recognition of these processes by the pathologist can be a valuable step in the characterization of underlying malignant diseases.
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Affiliation(s)
- Mark R Wick
- PRW Laboratories, Charlottesville, VA, United State.
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Han J, Wang S, Kwong TNY, Liu J. Dermatomyositis as an extrahepatic manifestation of hepatitis B virus-related hepatocellular carcinoma: A case report and literature review. Medicine (Baltimore) 2018; 97:e11586. [PMID: 30113453 PMCID: PMC6113031 DOI: 10.1097/md.0000000000011586] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
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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Affiliation(s)
- Juqiang Han
- Institute of Hepatology, PLA Army General Hospital, Beijing, PR China
| | - Shuai Wang
- Institute of Hepatology, PLA Army General Hospital, Beijing, PR China
| | - Thomas Ngai Yeung Kwong
- Department of Medicine and Therapeutic, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Jian Liu
- Department of Rheumatology, Aerospace Center Hospital, Beijing, PR China
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Yan L, Sethi S, Bitterman P, Reddy V, Gattuso P. Umbilical Lesions: Clinicopathologic Features of 99 Tumors. Int J Surg Pathol 2018; 26:417-422. [DOI: 10.1177/1066896918758916] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background. Umbilical lesions are rare, and can be benign or malignant. This retrospective study was conducted to assess the epidemiological, clinical, and histologic characteristics of umbilical masses. Methods. Cases of umbilical masses from January 1994 to August 2016 were retrieved from our institution’s pathology databases, and their clinicopathological features were reviewed. Results. There were a total of 99 cases of umbilical masses, 78 women (78.8%) and 21 men (21.2%). Of these, 59 were malignant (59.6%) and 40 were benign (40.4%). Among the malignant cases, 48 were women with a mean age of 65 years and 11 were men with a mean age of 66 years. All malignant lesions were secondary tumors. Twenty-five patients (42.3%) had a metastatic tumor to the umbilicus with an average of 7 months from the original diagnosis (12 gynecological, 8 pancreatic/gastrointestinal, 2 lymphomas, and a case each of breast, prostate, and melanoma). Of the patients with a benign diagnosis, 30 were women (75%) with a mean age of 52 years and 10 were men (25%) with a mean age of 43 years. The benign lesions included epidermal inclusion cysts (15/40), endometriosis (11/40), lipomas (3/40), neurofibromas (3/40), fibromas (3/40), abscesses (2/40), and 1 case each of tubular apocrine adenoma, serous cystadenoma, and calcified nodule. Conclusion. The most common metastatic tumors to the umbilicus are from the adjacent organs with the gynecologic tract as the most frequent primary followed by the gastrointestinal system. Primary malignant tumors of the umbilical region are rarely identified in clinical practice.
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Affiliation(s)
- Lei Yan
- Rush University Medical Center, Chicago, IL, USA
| | - Shenon Sethi
- Rush University Medical Center, Chicago, IL, USA
| | | | - Vijaya Reddy
- Rush University Medical Center, Chicago, IL, USA
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Paraneoplastic syndromes associated with gynecological cancers: A systematic review. Gynecol Oncol 2017; 146:661-671. [PMID: 28655412 DOI: 10.1016/j.ygyno.2017.06.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 06/19/2017] [Accepted: 06/19/2017] [Indexed: 11/23/2022]
Abstract
A number of paraneoplastic syndromes have been described with gynecological cancers. These syndromes are induced by substances secreted by the tumor or by an immune response triggered by the cancer. Each system of the human body can be affected by different syndromes. Indeed, paraneoplastic syndromes occurring from tumors of the gynecologic tract were found to involve the nervous, ophthalmologic, dermatologic, rheumatologic, endocrine, hematologic and renal systems. These syndromes can manifest before, at the time, or after the diagnosis of cancer. They can also occur at the time of a recurrence. Knowledge about these syndromes is important for physicians caring for patients with cancers, as they can result in severe morbidity and must be treated appropriately. Literature regarding paraneoplastic syndromes associated with tumors of the female genital tract is scattered and the subject has not been reviewed recently. A systematic literature search was thus conducted to identify paraneoplastic syndromes associated with gynecologic cancers. This review focuses on the cancers involved with each paraneoplastic syndrome, and on their pathophysiology, clinical manifestations, possible complications, outcomes, and treatments. As the mainstay of treatment in these conditions is often to address the underlying tumor, it is of upmost importance that physicians be aware of these rare cancer manifestations.
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Toz B, Büyükbabani N, İnanç M. Multicentric reticulohistiocytosis: Rheumatology perspective. Best Pract Res Clin Rheumatol 2016; 30:250-260. [DOI: 10.1016/j.berh.2016.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 07/13/2016] [Indexed: 12/22/2022]
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Adult Xanthogranuloma, Reticulohistiocytosis, and Rosai-Dorfman Disease. Dermatol Clin 2015; 33:465-72; discussion 473. [DOI: 10.1016/j.det.2015.03.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Dias LPN, Faria ALA, Scandiuzzi MM, Inhaia CLDS, Shida JY, Gebrim LH. A rare case of severe myositis as paraneoplastic syndrome on breast cancer. World J Surg Oncol 2015; 13:134. [PMID: 25890160 PMCID: PMC4397703 DOI: 10.1186/s12957-015-0534-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 03/07/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Dermatomyositis and polymyositis are both types of idiopathic inflammatory myositis characterized by inflammation and weakness of proximal skeletal muscles and skin rash. CASE A 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. TREATMENT At 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. DISCUSSION The 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. CONCLUSION Dermatomyositis 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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Affiliation(s)
- Leonardo Pires Novais Dias
- Department of Senology, Pérola Byington Hospital, Avenida Brigadeiro Luís Antônio 683, Bela Vista, , CEP, 01317-000,, São Paulo - SP, Brazil.
| | - Ana Luiza Antunes Faria
- Department of Senology, Pérola Byington Hospital, Avenida Brigadeiro Luís Antônio 683, Bela Vista, , CEP, 01317-000,, São Paulo - SP, Brazil.
| | - Maissa Marçola Scandiuzzi
- Department of Senology, Pérola Byington Hospital, Avenida Brigadeiro Luís Antônio 683, Bela Vista, , CEP, 01317-000,, São Paulo - SP, Brazil.
| | - Claudia Luci dos Santos Inhaia
- Department of Senology, Pérola Byington Hospital, Avenida Brigadeiro Luís Antônio 683, Bela Vista, , CEP, 01317-000,, São Paulo - SP, Brazil.
| | - Jorge Yoshinori Shida
- Department of Senology, Pérola Byington Hospital, Avenida Brigadeiro Luís Antônio 683, Bela Vista, , CEP, 01317-000,, São Paulo - SP, Brazil.
| | - Luiz Henrique Gebrim
- Department of Senology, Pérola Byington Hospital, Avenida Brigadeiro Luís Antônio 683, Bela Vista, , CEP, 01317-000,, São Paulo - SP, Brazil.
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Islam AD, Naguwa SM, Cheema GS, Hunter JC, Gershwin ME. Multicentric Reticulohistiocytosis: a Rare Yet Challenging Disease. Clin Rev Allergy Immunol 2013; 45:281-9. [DOI: 10.1007/s12016-013-8362-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Nolan C, Semer D. Endometrial cancer diagnosed by Sister Mary Joseph nodule biopsy: Case report. GYNECOLOGIC ONCOLOGY CASE REPORTS 2012; 2:110-1. [PMID: 24371637 DOI: 10.1016/j.gynor.2012.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Accepted: 06/11/2012] [Indexed: 10/28/2022]
Affiliation(s)
- Christy Nolan
- Brody School of Medicine at East Carolina University, PCMH TA 165, Greenville, NC 27834, USA
| | - Diane Semer
- Gynecologic Oncologist, Physicians East, P.A., USA
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Mathew RA, Bennett JM, Liu JJ, Komrokji RS, Lancet JE, Naghashpour M, Messina JL, List AF, Moscinski LC, Zhang L. Cutaneous manifestations in CMML: Indication of disease acceleration or transformation to AML and review of the literature. Leuk Res 2012; 36:72-80. [DOI: 10.1016/j.leukres.2011.05.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 05/01/2011] [Accepted: 05/04/2011] [Indexed: 10/18/2022]
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Current world literature. Curr Opin Pediatr 2011; 23:492-7. [PMID: 21750430 DOI: 10.1097/mop.0b013e3283496fc1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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