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罕见的局部晚期三阴性乳腺癌伴副肿瘤性皮肌炎诊断:一例报告及文献综述

Rare diagnosis of locally advanced triple‑negative breast cancer with paraneoplastic dermatomyositis: A case report and literature review.

作者信息

Song Yu, Xu Ying, Huang Xin, Sun Qiang, Lin Yan

机构信息

Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, P.R. China.

出版信息

Oncol Lett. 2025 Apr 23;29(6):309. doi: 10.3892/ol.2025.15055. eCollection 2025 Jun.

Abstract

Paraneoplastic dermatomyositis (DM) is a rare autoimmune condition that primarily affects the skin and muscles; it is associated with various malignancies, including breast cancer. The present case report investigates the clinical presentation, therapeutic considerations and relevant literature regarding DM in the context of locally advanced triple-negative breast cancer (TNBC). A 43-year-old female patient presented with progressive myalgia, dysphagia and characteristic skin rashes. Subsequent investigations confirmed locally advanced TNBC and concomitant DM. Due to the severely weakened state of the patient, the standard treatment of neoadjuvant chemotherapy was contraindicated. The patient initially received corticosteroid therapy, which led to partial symptom improvement, followed by a modified radical mastectomy and adjuvant chemotherapy. Following surgical intervention, the patient experienced significant alleviation of DM symptoms. The present study underscores the critical role of early malignancy identification and intervention in managing DM associated with breast cancer; in addition, it explores the epidemiology, risk factors, pathogenesis, diagnostic modalities and treatment strategies for breast cancer-associated DM. The potential challenges in treatment selection are highlighted, particularly in patients with severe presentations. Mastectomy can emerge as a viable therapeutic option to achieve symptom control and facilitate subsequent oncological management.

摘要

副肿瘤性皮肌炎(DM)是一种罕见的自身免疫性疾病,主要影响皮肤和肌肉;它与包括乳腺癌在内的各种恶性肿瘤有关。本病例报告探讨了局部晚期三阴性乳腺癌(TNBC)背景下DM的临床表现、治疗考量及相关文献。一名43岁女性患者出现进行性肌痛、吞咽困难及特征性皮疹。后续检查确诊为局部晚期TNBC并伴有DM。由于患者身体状况严重虚弱,新辅助化疗的标准治疗方法被禁用。患者最初接受了皮质类固醇治疗,症状得到部分改善,随后进行了改良根治性乳房切除术及辅助化疗。手术干预后,患者的DM症状明显缓解。本研究强调了早期识别恶性肿瘤并进行干预在管理与乳腺癌相关的DM中的关键作用;此外,还探讨了乳腺癌相关DM的流行病学、危险因素、发病机制、诊断方法及治疗策略。突出了治疗选择中的潜在挑战,尤其是在症状严重的患者中。乳房切除术可成为实现症状控制并便于后续肿瘤管理的可行治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db51/12056477/ce5cf83a3be2/ol-29-06-15055-g00.jpg

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