Venkatesh Priyanka, Hitchcock Sophia M, Jacobsohn Jamie, Kasi Anup
Medical Oncology, University of Kansas Medical Center, Kansas City, USA.
Internal Medicine, Kempegowda Institute of Medical Sciences/Rajiv Gandhi University of Health Sciences, Bangalore, IND.
Cureus. 2020 Oct 12;12(10):e10916. doi: 10.7759/cureus.10916.
Our case report describes a 60-year-old female patient with a past medical history of Stage IB breast cancer, status post lumpectomy and adjuvant chemotherapy, admitted to our hospital with the chief complaints of fever, myalgia, and muscle weakness. A physical exam revealed proximal muscle weakness and a facial rash. A full workup was done, and the muscle biopsy showed evidence of a necrotizing myopathic process, which confirmed our diagnosis. This led to a diagnosis of necrotizing myopathy, deemed to be paraneoplastic after other possible differentials were ruled out. The patient showed improvement after a five-day course of intravenous immunoglobulin (IVIG) and high-dose steroids. Necrotizing myopathy, as a paraneoplastic process, has been scarcely described. In the context of our case, we review the characteristics and relevant existing literature about paraneoplastic necrotizing myopathy as well as emphasize the need to include it as a differential in the setting of malignancy.
我们的病例报告描述了一名60岁女性患者，既往有IB期乳腺癌病史，接受过肿块切除术和辅助化疗，因发热、肌痛和肌肉无力为主诉入院。体格检查发现近端肌肉无力和面部皮疹。进行了全面检查，肌肉活检显示有坏死性肌病过程的证据，这证实了我们的诊断。这导致诊断为坏死性肌病，在排除其他可能的鉴别诊断后，被认为是副肿瘤性的。患者在接受为期五天的静脉注射免疫球蛋白（IVIG）和大剂量类固醇治疗后病情有所改善。坏死性肌病作为一种副肿瘤性疾病，鲜有描述。结合我们的病例，我们回顾了副肿瘤性坏死性肌病的特征和相关现有文献，并强调在恶性肿瘤情况下将其作为鉴别诊断的必要性。
