From the Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical Faculty, University of Istanbul-Cerrahpasa, Istanbul, Turkey.
J Clin Rheumatol. 2021 Jun 1;27(4):168-171. doi: 10.1097/RHU.0000000000001048.
There is a well-known association between malignancy and dermatomyositis but reports of an association between malignancies of the thyroid gland and dermatomyositis are very few. Here we describe a recent case of dermatomyositis found to have thyroid cancer during screening and review the clinical features of the similar cases in literature.
The case history, treatment responses and follow up data are described. We performed a systematic literature review using the keywords (thyroid cancer OR thyroid carcinoma) AND dermatomyositis.
35 year old male presented with an acute onset of symptoms including facial rash, widespread myalgia, muscle weakness and dysphagia. Patient was diagnosed with dermatomyositis based on clinical findings, laboratory, electromyography and imaging results and immunosuppressive treatment initiated. Screening for cancer revealed a papillary thyroid carcinoma. Thyroidectomy was performed and immunosuppressive medication was gradually tapered and stopped. At 24 months following the diagnosis patient remains in remission. This is the 14th reported case of dermatomyositis and thyroid cancer in the English literature. Analysis of data from these 14 cases while revealing conflicting insights about the link between dermatomyositis and thyroid cancer do not rule out this possibility. Treatment of thyroid cancer appeared to have a significant influence on the course of dermatomyositis in at least six of these cases.
Better recognition of the link between dermatomyositis and thyroid cancer may allow physicians to protect some dermatomyositis patients from morbidity and mortality associated with immunosuppression.
恶性肿瘤与皮肌炎之间存在众所周知的关联，但有关甲状腺恶性肿瘤与皮肌炎之间关联的报道却很少。在此，我们描述了一例近期发现的皮肌炎病例，该病例在筛查期间发现患有甲状腺癌，并回顾了文献中类似病例的临床特征。
描述了该病例的病史、治疗反应和随访数据。我们使用关键词（甲状腺癌 OR 甲状腺癌）和皮肌炎进行了系统的文献回顾。
一名 35 岁男性出现急性症状，包括面部皮疹、广泛肌肉疼痛、肌肉无力和吞咽困难。根据临床发现、实验室、肌电图和影像学结果，患者被诊断为皮肌炎，并开始接受免疫抑制治疗。癌症筛查发现甲状腺乳头状癌。进行了甲状腺切除术，并逐渐减少和停止使用免疫抑制药物。在诊断后的 24 个月，患者仍处于缓解状态。这是英文文献中第 14 例皮肌炎和甲状腺癌的报道。对这 14 例病例的数据进行分析，虽然对皮肌炎与甲状腺癌之间的联系提出了相互矛盾的观点，但并不能排除这种可能性。在这些病例中，至少有 6 例甲状腺癌的治疗对皮肌炎的病程有显著影响。
更好地认识皮肌炎与甲状腺癌之间的联系，可能使医生能够保护一些皮肌炎患者免受与免疫抑制相关的发病率和死亡率。
