Soutif Charles, Tison Thaïs, Focant Isabelle, Seront Emmanuel
Department of medical oncology, Hopital de Jolimont, Haine Saint Paul, 7100, Belgium.
Department of rheumatology, Hopital de Jolimont, Haine Saint Paul, 7100, Belgium.
Future Sci OA. 2021 Jun 30;7(5):FSO706. doi: 10.2144/fsoa-2021-0011.
A 72-year-old woman was diagnosed with metastatic colorectal cancer and treated with oxaliplatin-based chemotherapy and bevacizumab. One week after the second administration of chemotherapy, she presented acute-onset dysphagia and rapidly progressing proximal muscle weakness, associated with elevation of the creatinine phosphokinase enzymes. Magnetic resonance imaging raised suspicion of polymyositis. Etiology remained unclear but paraneoplastic origin or immune modulation by chemotherapy was considered. High-dose methylprednisolone and intravenous immunoglobulins were started with continuation of chemotherapy. Although there was rapid normalization of muscle enzyme, the general status deteriorated rapidly with aggravation of dysphagia, complete immobilization and death. This case highlights the importance of considering muscle weakness as paraneoplastic syndrome or drug-induced toxicity in colorectal cancer patients. Despite aggressive management, prognosis remains poor.
一名72岁女性被诊断为转移性结直肠癌，接受了以奥沙利铂为基础的化疗和贝伐单抗治疗。在第二次化疗给药一周后，她出现急性吞咽困难和迅速进展的近端肌无力，并伴有肌酸磷酸激酶升高。磁共振成像引发了对多发性肌炎的怀疑。病因仍不明确，但考虑为副肿瘤性起源或化疗引起的免疫调节。开始使用大剂量甲泼尼龙和静脉注射免疫球蛋白，并继续化疗。尽管肌肉酶迅速恢复正常，但随着吞咽困难加重、完全无法活动和死亡，患者的总体状况迅速恶化。该病例凸显了在结直肠癌患者中考虑肌无力为副肿瘤综合征或药物诱导毒性的重要性。尽管采取了积极治疗，预后仍然很差。
