Department of Endocrinology, Diabetes and Metabolism, Mayo Clinic, Rochester, Minnesota.
Endocr Pract. 2013 Nov-Dec;19(6):e154-7. doi: 10.4158/EP13145.CR.
Dermatomyositis (DM) is considered a paraneoplastic phenomenon and cancer may precede or follow the development of clinical features by several years. Despite the prevalence of thyroid cancer, reports of an association are rare. We report 3 cases of dermatomyositis and thyroid cancer, focusing on the clinical course of the rheumatologic condition following thyroidectomy. We also performed a comprehensive review of the current literature.
We performed a chart review between 1960 and 2012 to identify patients with DM and papillary thyroid cancer (PTC) seen in Mayo Clinic, Rochester, in Minnesota, a tertiary referral center. Only 3 patients were identified using the above criteria.
There was a significant improvement in the course of the dermatological condition after definitive treatment for thyroid cancer (i.e. thyroidectomy) in one of our patients. The risk of a first malignancy is highest at the time the diagnosis of dermatomyositis is made and remains significantly higher in the first two years following diagnosis. A comprehensive literature review identified only two patients with PTC and dermatomyositis (both in Taiwan) across 4 international population cohorts. In addition, several cases have been reported from patients in the Far East, a geographical predilection that is unexplained.
Our case series highlights the uncommon association between thyroid cancer and dermatomyositis while illustrating prevailing knowledge about the temporal relationship between dermatomyositis and thyroid cancer. Increased vigilance for and treatment of thyroid cancer in patients with dermatomyositis may assist in the successful management of this difficult rheumatologic condition.
皮肌炎（DM）被认为是一种副瘤现象，癌症可能在临床特征出现前数年或后数年发生。尽管甲状腺癌的发病率较高，但有关其相关性的报道却很少。我们报告了 3 例皮肌炎和甲状腺癌患者，重点关注甲状腺切除术后风湿状况的临床病程。我们还对当前文献进行了全面复习。
我们对 1960 年至 2012 年期间在明尼苏达州罗彻斯特的梅奥诊所就诊的皮肌炎和甲状腺乳头状癌（PTC）患者进行了病历回顾，这是一家三级转诊中心。仅使用上述标准确定了 3 例患者。
在对甲状腺癌（即甲状腺切除术）进行明确治疗后，我们的 1 名患者的皮肤病况有了显著改善。在诊断皮肌炎时，发生首次恶性肿瘤的风险最高，在诊断后的头两年内仍然显著升高。全面的文献复习仅在 4 个国际人群队列中发现了 2 例 PTC 和皮肌炎患者（均在台湾）。此外，远东地区也有一些来自患者的病例报告，这种地理倾向尚无解释。
我们的病例系列强调了甲状腺癌与皮肌炎之间罕见的关联，同时说明了皮肌炎与甲状腺癌之间的时间关系的普遍认识。提高对皮肌炎患者甲状腺癌的警惕性并进行治疗可能有助于成功管理这种困难的风湿性疾病。
