Yu Xiaomin, Qin Dongyan, Ma Dehua, Yao Qin
Department of Obstetrics and Gynaecology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China; Department of Obstetrics and Gynaecology, The Eighth People's Hospital of Qingdao, Qingdao, Shandong 266100, P.R. China.
Department of Obstetrics and Gynaecology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China.
Oncol Lett. 2016 Apr;11(4):2611-2614. doi: 10.3892/ol.2016.4251. Epub 2016 Feb 19.
A 27-year-old female patient presented with a 3-month history of bilateral orbital and facial edema accompanied by skin erythema and heliotrope rash. The left lesion was more critical than the right. Limb muscles were occasionally sore. On physical examination, scattered hemorrhagic rashes were observed on the patient's face and neck. Upon laboratory testing, creatine kinase (CK) was markedly elevated at 1,543.2 U/l, while CK-MB isoenzyme (27.4 U/l), α-hydroxybutyric dehydrogenase (188.4 U/l) and aspartate aminotransferase (65.3 U/l) were marginally elevated. The patient was diagnosed with dermatomyositis due to the dermatological features and elevated CK. Cancer marker analysis revealed positivity for carbohydrate antigen 125 (68.15 U/ml). Magnetic resonance imaging revealed thickening of the soft tissue of the left eyelid; furthermore, concurrent long T1- and T2-weighted signals (fat saturation) were compatible with inflammatory infiltration. Non-enhanced computed tomography identified that the right accessory region (right ovary and fallopian tube) had a cystic mass with a significant fat component and thickening of the anterior uterine wall. Gynecological ultrasound findings indicated an ovarian teratoma (8.7×7.8×9.3 cm) and uterine myoma (3.6×3.1 cm). The patient's dermatological symptoms and laboratory results were significantly relieved one week after surgical removal of the teratoma with the aid of hydrocortisone, methylprednisolone and methotrexate therapy.
一名27岁女性患者，双侧眼眶及面部水肿伴皮肤红斑和向阳疹3个月。左侧病变比右侧严重。肢体肌肉偶尔疼痛。体格检查发现患者面部和颈部有散在出血性皮疹。实验室检查显示，肌酸激酶（CK）显著升高至1543.2 U/l，而CK-MB同工酶（27.4 U/l）、α-羟丁酸脱氢酶（188.4 U/l）和天冬氨酸转氨酶（65.3 U/l）轻度升高。由于皮肤特征和CK升高，该患者被诊断为皮肌炎。肿瘤标志物分析显示糖类抗原125阳性（68.15 U/ml）。磁共振成像显示左侧眼睑软组织增厚；此外，同时出现的长T1和T2加权信号（脂肪抑制）符合炎症浸润表现。非增强计算机断层扫描发现右侧附件区（右卵巢和输卵管）有一个含有大量脂肪成分的囊性肿块，子宫前壁增厚。妇科超声检查结果显示为卵巢畸胎瘤（8.7×7.8×9.3 cm）和子宫肌瘤（3.6×3.1 cm）。在借助氢化可的松、甲泼尼龙和甲氨蝶呤治疗切除畸胎瘤一周后，患者的皮肤症状和实验室检查结果明显缓解。
