Guan Xiaomin, Qiu Shi, Xu Yinghui, Zu Jianjiao, Sun Chao, Guo Ye, Wang Xu, Ma Kewei
Cancer Center, The First Hospital of Jilin University, Changchun, Jilin, China.
Dermatology Department, The First Hospital of Jilin University, Changchun, Jilin, China.
Front Oncol. 2024 Feb 12;14:1325991. doi: 10.3389/fonc.2024.1325991. eCollection 2024.
Dermatomyositis represents an autoimmune disorder characterized by notable skin and muscular manifestations. The annual incidence of dermatomyositis stands at approximately (5~10)/1 million individuals. Notably, patients with malignant tumors exhibit an elevated risk of developing dermatomyositis compared to the general population. However, in cases where dermatomyositis co-occurs with malignancy, the efficacy of hormone therapy alone tends to be suboptimal. Moreover, reports addressing the correlation between tumor treatment and the management of dermatomyositis are scarce. A 60-year-old male patient presented with dermatomyositis, initially manifesting through symptoms such as rash, muscle weakness, and dysphagia. Despite undergoing standard hormone therapy, there was no discernible improvement in the dermatomyositis symptoms. Considering the patient's concomitant troublesome cough, further investigations were conducted, including CT, PET-CT, and pathological biopsy. These assessments confirmed the diagnosis of limited-stage small cell lung cancer (T1cN3M0 IIIB). Notably, in this patient, dermatomyositis was suspected to be a paraneoplastic syndrome associated with small cell lung cancer. Standard chemotherapy and radiotherapy were employed to treat the small cell lung cancer, resulting in partial remission after two treatment cycles. As the malignancy regressed, a notable improvement in dermatomyositis symptoms was observed, subsequently leading to a gradual reduction in the prescribed hormone dosage. In conclusion, we present a comprehensive case study of dermatomyositis as a paraneoplastic syndrome throughout the treatment process. The response to tumor therapy coincided with the amelioration of dermatomyositis symptoms. Therefore, diligent malignancy screening is imperative for patients diagnosed with dermatomyositis.
皮肌炎是一种自身免疫性疾病，其特征为明显的皮肤和肌肉表现。皮肌炎的年发病率约为每100万人中有（5~10）例。值得注意的是，与普通人群相比，患有恶性肿瘤的患者患皮肌炎的风险更高。然而，在皮肌炎与恶性肿瘤同时发生的情况下，单独使用激素治疗的效果往往不理想。此外，关于肿瘤治疗与皮肌炎管理之间相关性的报道很少。一名60岁男性患者出现皮肌炎，最初表现为皮疹、肌肉无力和吞咽困难等症状。尽管接受了标准的激素治疗，但皮肌炎症状并无明显改善。考虑到患者伴有令人困扰的咳嗽，进一步进行了包括CT、PET-CT和病理活检在内的检查。这些评估确诊为局限期小细胞肺癌（T1cN3M0 IIIB期）。值得注意的是，在该患者中，皮肌炎被怀疑是与小细胞肺癌相关的副肿瘤综合征。采用标准的化疗和放疗来治疗小细胞肺癌，两个治疗周期后病情部分缓解。随着恶性肿瘤的消退，观察到皮肌炎症状有明显改善，随后导致所开激素剂量逐渐减少。总之，我们展示了一个在整个治疗过程中将皮肌炎作为副肿瘤综合征的综合病例研究。对肿瘤治疗的反应与皮肌炎症状的改善相一致。因此，对于诊断为皮肌炎的患者，必须进行仔细的恶性肿瘤筛查。
