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Fujino M, Kawashima M, Yoshifuji H, Nakashima R, Yamada Y, Matsumoto Y, Kawaguchi-Sakita N, Mori Y, Pu F, Yamaguchi A, Kawaguchi K, Takada M, Toi M. Remarkable remission of symptomatic dermatomyositis after curative breast cancer surgery. Int Cancer Conf J 2024; 13:111-118. [PMID: 38524641 PMCID: PMC10957833 DOI: 10.1007/s13691-023-00646-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 12/10/2023] [Indexed: 03/26/2024] Open
Abstract
Dermatomyositis (DM) is an autoimmune disease that causes proximal muscle weakness in the extremities leading to severe immobility and dysphagia. Approximately 20% of patients with DM are positive for anti-TIF-1γ antibody and frequently accompanied by malignant tumors. Although DM remission after tumor resection has been reported, the indications for surgery in patients with severe DM are unknown. Herein, we report a case of a 79-year-old Japanese woman who presented with breast cancer and anti-TIF-1γ antibody-positive DM. She became bedridden shortly after DM onset. Although pulsed steroid therapy, intravenous immunoglobulin, tacrolimus, and endocrine therapy with fulvestrant did not improve her symptoms, tumor resection with axillary lymph node dissection resulted in complete remission of the DM after 8 months. Immunohistochemistry revealed high expression of TIF-1γ in cancer cells, both in the primary tumor and axillary lymph nodes. Since the serum levels of anti-TIF-1γ antibody decreased after the surgery, the existence of breast cancer with TIF-1γ expression may have contributed to the worsening of DM. The present case suggests that curative surgery should be considered as a treatment option even if the patient has severe symptoms, such as immobility and dysphagia. Careful discussions with patients and multidisciplinary collaboration are essential to make surgery feasible, particularly for those with severe symptomatic DM.
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Affiliation(s)
- Makoto Fujino
- Department of Breast Surgery, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507 Japan
- Department of Breast Surgery, Uji Tokushukai Hospital, 145 Ishibashi, Makishima-cho, Uji City, Kyoto 6110041 Japan
| | - Masahiro Kawashima
- Department of Breast Surgery, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507 Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507 Japan
| | - Ran Nakashima
- Department of Rheumatology and Clinical Immunology, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507 Japan
| | - Yosuke Yamada
- Department of Diagnostic Pathology, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507 Japan
| | - Yoshiaki Matsumoto
- Department of Breast Surgery, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507 Japan
| | - Nobuko Kawaguchi-Sakita
- Department of Clinical Oncology, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507 Japan
| | - Yukiko Mori
- Department of Clinical Oncology, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507 Japan
| | - Fengling Pu
- Department of Breast Surgery, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507 Japan
| | - Ayane Yamaguchi
- Department of Breast Surgery, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507 Japan
| | - Kosuke Kawaguchi
- Department of Breast Surgery, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507 Japan
| | - Masahiro Takada
- Department of Breast Surgery, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507 Japan
| | - Masakazu Toi
- Department of Breast Surgery, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 6068507 Japan
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Haber R, Feghali J, Nadir U, Yi MD, Cahn BA. Acquired ichthyosis: a clinical review. Arch Dermatol Res 2023; 315:2529-2543. [PMID: 37422878 DOI: 10.1007/s00403-023-02668-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/06/2023] [Accepted: 06/28/2023] [Indexed: 07/11/2023]
Abstract
Acquired ichthyosis (AI) is a rare, nonhereditary cutaneous disorder that has been associated with numerous neoplastic, infectious, drugs, endocrine, metabolic, autoimmune, and malabsorptive diseases. Review all demographical, clinical, histological, and therapeutic features of AI and focus on all reported associated diseases. We performed a systematic literature review in Pubmed/Medline, Embase, and Cochrane collaboration databases, searching for all articles on AI, with no limits on publication date, participant age, sex or nationality. Eighty-four articles were included. Total number of included patients was 167 patients with a mean age at presentation of 39 years [range 0.5-85] and a sex ratio M:F of 5:2. The most common malignancy associated with AI is Hodgkin's lymphoma. AI occurred before, simultaneously or after the onset of malignancy or systemic disease. The severity of AI depends on the severity of the underlying disorder and regresses once the disease goes into remission and may also be a marker of disease recurrence or relapse. 8% have been reported to be drug related and all occurred weeks to months after drug intake and resolved after stopping or decreasing the dose of the drug. Data were derived from case reports and observational studies. Limitations include the accuracy of published data, potential patient selection, and reporting bias. AI can be associated with numerous systemic diseases and drugs. Physicians should be particularly alert to these associations to provide adequate screening and management of patients with AI.
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Affiliation(s)
- Roger Haber
- Department of Dermatology, University of Illinois-Chicago, 808 South Wood Street (MC 624), Suite 380 College of Medicine East Tower, Chicago, IL, 60612, USA
| | - Joelle Feghali
- Department of Dermatology, Saint George Hospital University Medical Center, Beirut, Lebanon
- Faculty of Medicine, Balamand University, El-Koura, Lebanon
| | - Umer Nadir
- Department of Dermatology, Feinberg School of Medicine, Chicago, IL, USA
| | - Michael D Yi
- Department of Dermatology, Feinberg School of Medicine, Chicago, IL, USA
| | - Brian A Cahn
- Department of Dermatology, University of Illinois-Chicago, 808 South Wood Street (MC 624), Suite 380 College of Medicine East Tower, Chicago, IL, 60612, USA.
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Bernardi D, Asti E, Bonavina G, Luporini A, Clemente C, Bonavina L. Delayed presentation of inflammatory breast carcinoma during the COVID-19 pandemic. Eur Surg 2022; 54:212-216. [PMID: 34149833 PMCID: PMC8204297 DOI: 10.1007/s10353-021-00726-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 05/04/2021] [Indexed: 01/07/2023]
Abstract
Background Breast cancer may present with distinct cutaneous manifestations that may be paraneoplastic or secondary to direct skin infiltration, distant skin metastases, or dermal lymphatic tumor embolization (inflammatory breast carcinoma). Case report A 51-year-old Asian woman visited the emergency care department during the outbreak of COVID-19 in Northern Italy. About 6 months before, she had noted the onset of right breast swelling accompanied by skin redness and itching. She never consulted a physician, and, over time, the local skin condition progressed to a large scaly plaque covering the entire breast surface including the nipple. At presentation, abduction of the right upper limb was impaired due to severe shoulder pain. CT scan showed the presence of bilateral breast masses with necrotic and colliquative features, and multiple skeletal, nodal, pulmonary, and brain images suggestive of metastases. An ultrasound-guided core biopsy of the contralateral breast showed grade 2 non-special type infiltrating carcinoma. The patient was referred to the breast oncology unit and is currently being treated with aromatase inhibitors and chemotherapy. Conclusion The COVID-19 pandemic has disrupted the entire spectrum of oncological care including breast cancer. Hopefully, telemedicine will contribute to increase patients' confidence and will provide earlier diagnosis and treatment while minimizing the risk of contagion.
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Affiliation(s)
- Daniele Bernardi
- Department of Biomedical Sciences for Health, Division of General Surgery, University of Milan, Milan, Italy
| | - Emanuele Asti
- Department of Biomedical Sciences for Health, Division of General Surgery, University of Milan, Milan, Italy
| | - Giulia Bonavina
- Department of Gynecology, Vita e Salute University, Ospedale San Raffaele, Milan, Italy
| | - Alberto Luporini
- Medical Oncology Unit, IRCCS Policlinico San Donato, Milan, Italy
| | - Claudio Clemente
- Pathology and Cytopathology Unit, IRCCS Policlinico San Donato, Milan, Italy
| | - Luigi Bonavina
- IRCCS Policlinico San Donato, Piazza Edmondo Malan 1, San Donato Milanese, 20097 Milan, Italy
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Piras M, Panebianco M, Garibaldi M, Roberto M, Merlonghi G, Pellegrini P, Marchetti P. A Case of Pathological Complete Response and Resolution of Dermatomyositis Following Neoadjuvant Chemotherapy in HER2-Positive Early Breast Cancer. Curr Oncol 2021; 28:1957-1961. [PMID: 34073827 PMCID: PMC8161769 DOI: 10.3390/curroncol28030182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/07/2021] [Accepted: 05/19/2021] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Dermatomyositis (DM) is an idiopathic inflammatory myopathy (IIM) mainly characterized by subacute muscle weakness and skin rash sometimes associated with malignancy. CASE PRESENTATION A 61-year-old female was admitted to our hospital because of progressive proximal muscular weakness, heliotropic rash and left breast rash. Muscle biopsy findings were consistent with dermatomyositis (DM). A full panel of myositis associated (MAA) and specific antibodies (MSA) revealed the presence of anti-nuclear antibodies (1:160, speckled), Anti-Ro52 and anti TIF1-γ antibodies. A whole body Computed Tomography Scan showed three left mammary nodules and homolateral axillary lymphadenopathy. The breast biopsy confirmed the diagnosis of ductal carcinoma. Patient was initiated to neoadjuvant chemotherapy followed by surgery for cancer, and corticosteroid and intravenous immunoglobulins for DM with a complete resolution of muscle weakness and pathological complete response of breast cancer. Discussion and conclusion. Similar cases in literature are commonly referred to a first-line surgery and the role of neoadjuvant chemotherapy is debatable.
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Affiliation(s)
- Marta Piras
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, University “La Sapienza”, 00189 Rome, Italy; (M.P.); (M.P.); (P.P.); (P.M.)
| | - Martina Panebianco
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, University “La Sapienza”, 00189 Rome, Italy; (M.P.); (M.P.); (P.P.); (P.M.)
| | - Matteo Garibaldi
- Neuromuscular and Rare Disease Centre, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), SAPIENZA University of Rome, Sant’Andrea Hospital, 00189 Rome, Italy; (M.G.); (G.M.)
| | - Michela Roberto
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, University “La Sapienza”, 00189 Rome, Italy; (M.P.); (M.P.); (P.P.); (P.M.)
| | - Gioia Merlonghi
- Neuromuscular and Rare Disease Centre, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), SAPIENZA University of Rome, Sant’Andrea Hospital, 00189 Rome, Italy; (M.G.); (G.M.)
| | - Patrizia Pellegrini
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, University “La Sapienza”, 00189 Rome, Italy; (M.P.); (M.P.); (P.P.); (P.M.)
| | - Paolo Marchetti
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, University “La Sapienza”, 00189 Rome, Italy; (M.P.); (M.P.); (P.P.); (P.M.)
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Milam EC, Rangel LK, Pomeranz MK. Dermatologic sequelae of breast cancer: From disease, surgery, and radiation. Int J Dermatol 2020; 60:394-406. [PMID: 33226140 DOI: 10.1111/ijd.15303] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/02/2020] [Accepted: 10/15/2020] [Indexed: 01/24/2023]
Abstract
The care of breast cancer patients is important to dermatologists. Breast cancer's initial presentation, clinical progression, and its associated treatments can result in a variety of cutaneous complications. Dermatologists may be the first to identify a breast cancer diagnosis, as a subset of patients first present with direct extension of an underlying tumor or with a cutaneous metastasis. The surgical treatment of breast cancer also begets a variety of skin sequelae, including postoperative lymphedema, soft tissue infections, seromas, pyoderma gangrenosum, and scarring disorders. Moreover, breast cancer radiation treatment commonly results in skin changes, which can range from mild and temporary dermatoses to chronic and disfiguring skin ulceration, fibrosis, and necrosis. Radiation may also precipitate secondary malignancies, such as angiosarcoma, as well as rarer dermatologic diseases, such as radiation-induced morphea, lichen planus, and postirradiation pseudosclerodermatous panniculitis. Finally, breast cancer is also associated with an array of paraneoplastic phenomena, including Sweet's syndrome and the rarer intralymphatic histiocytosis. Herein, we review the dermatological manifestations of breast cancer, including conditions associated with its presentation, progression, and treatment sequelae. Chemotherapy-induced cutaneous side effects are beyond the scope of this review. This article provides a comprehensive review for dermatologist to be able to identify, diagnose, and manage breast cancer patients from initial presentation to treatment monitoring and subsequent follow-up.
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Affiliation(s)
- Emily C Milam
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA
| | - Lauren K Rangel
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA
| | - Miriam K Pomeranz
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA
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Otsuka Y, Watanabe H, Kano Y, Tatebe N, Sunahori-Watanabe K, Kawabata T, Sada KE, Wada J. Occurrence of Dermatomyositis Immediately after Mastectomy Subsequent to Severe Chemotherapeutic Drug Eruption. Intern Med 2017; 56:3379-3383. [PMID: 29249766 PMCID: PMC5790732 DOI: 10.2169/internalmedicine.9194-17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 04/24/2017] [Indexed: 12/18/2022] Open
Abstract
We herein report a patient with breast cancer who developed dermatomyositis (DM) immediately after mastectomy. She had a history of severe drug eruption during neoadjuvant chemotherapy six months previously. Within a month after the operation, myalgia and rash, including Gottron's papules, developed, and skeletal-muscle enzymes elevated, so she was diagnosed with probable DM according to the Bohan and Peter criteria. In many neoplastic DM cases, the course of the disease parallels the course of the malignancy. Possible mechanisms were suggested to explain the development of DM in the present case and offer new insight into autoimmune diseases.
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Affiliation(s)
- Yuki Otsuka
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
- Okayama University Medical School, Japan
| | - Haruki Watanabe
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Yuzuki Kano
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Noriko Tatebe
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Katsue Sunahori-Watanabe
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Tomoko Kawabata
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Ken-Ei Sada
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Jun Wada
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
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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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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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Paget's Disease of the Breast in a Patient with Amyopathic Dermatomyositis. Case Rep Med 2012; 2012:515691. [PMID: 23049567 PMCID: PMC3459358 DOI: 10.1155/2012/515691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 08/23/2012] [Accepted: 08/26/2012] [Indexed: 11/18/2022] Open
Abstract
Amyopathic dermatomyositis (AD) can be a part of paraneoplastic syndrome of an underlying malignancy. Paget's disease is a rare form of breast cancer. We present a very rare case of Paget's disease associated with AD. Paget's disease has been diagnosed in a patient with AD who is under surveillance of dermatology department. The patient has undergone central lumpectomy with removal of the nipple-areola complex and sentinel lymph node biopsy. Surgical margins after lumpectomy and sentinel node biopsy were negative. The whole breast irradiation was performed after surgery. The patient receives medical treatment for AD of which lesions regressed in 1 year during the follow-up period. This is a very rare case of Paget's disease diagnosed in a patient with AD. Female patients with dermatomyositis have been absolutely recommended to undergo screening for breast and gynaecological malignancies. AD may be an early finding of primary or recurrent malignancy of the breast.
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Invasive ductal breast cancer associated polymyositis causing respiratory failure. Breast Cancer Res Treat 2010; 126:211-4. [PMID: 20931277 DOI: 10.1007/s10549-010-1192-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Accepted: 09/21/2010] [Indexed: 10/19/2022]
Abstract
Polymyositis (PM) is a very rare paraneoplastic syndrome in association with breast cancer, here we present a breast cancer patient with a sudden onset of respiratory failure caused by PM. A 47-year-old woman, with a history of a lump in her right breast for 3 months, weakness and anorexia for about 1 month, suddenly presented with respiratory failure and elevated muscle enzymes. Muscle biopsy revealed myositis and breast biopsy was consistent with invasive ductal breast cancer. Decreases of muscle enzyme levels were observed after corticosteroid therapy and the lumpectomy, but the patient died from respiratory failure. A case of respiratory failure caused by breast cancer associated polymyositis was presented. This case server to remind that breast cancer patients with muscle weakness or muscle enzyme elevation may be involved with PM.
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