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A rare case of severe myositis as paraneoplastic syndrome on breast cancer

Overview of attention for article published in World Journal of Surgical Oncology, April 2015
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Title
A rare case of severe myositis as paraneoplastic syndrome on breast cancer
Published in
World Journal of Surgical Oncology, April 2015
DOI 10.1186/s12957-015-0534-5
Pubmed ID
Authors

Leonardo Pires Novais Dias, Ana Luiza Antunes Faria, Maissa Marçola Scandiuzzi, Claudia Luci dos Santos Inhaia, Jorge Yoshinori Shida, Luiz Henrique Gebrim

Abstract

Dermatomyositis and polymyositis are both types of idiopathic inflammatory myositis characterized by inflammation and weakness of proximal skeletal muscles and skin rash. A 49-year-old Caucasian woman recently diagnosed with breast cancer classified as T1N2M0, stage IIIA, presenting skin rash associated with heliotrope and Gottron's papules. In addition, there was a progression to a severe reduction in proximal muscle strength with severe dysphagia. The initial treatment was conducted, and the patient recovered from all symptoms and followed adjuvant cancer management. At first, high dose of corticosteroid was administered as pulse therapy, and a radical mastectomy was indicated due to the severe symptoms of the paraneoplastic syndrome. Then chemotherapy and radiotherapy were applied, and oral corticoid associated with immunosupressive drug was administered for dermatomyositis control. The association between myositis and an increased risk of cancer has been demonstrated over the years. This patient has a high probability of dermatomyositis diagnosis. The initial treatment with high dose of glucocorticoids may result in an improvement of muscle lesions. Second-line treatment with azathioprine, methotrexate, or cyclophosphamide may be required for aggressive disease. Removal of the cancer induces improvement of paraneoplastic syndrome. Dermatomyositis can be a clinical manifestation of a paraneoplastic syndrome in patients with breast cancer. It is a rare diagnosis, and there is little evidence to guide treatment until now. It is possible to control the evolution of dermatomyositis with high doses of glucocorticoids in almost all cases; however, in severe cases of paraneoplastic syndrome, cancer treatment should start immediately.

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Mendeley readers

The data shown below were compiled from readership statistics for 45 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 2%
Unknown 44 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 10 22%
Student > Bachelor 8 18%
Student > Ph. D. Student 4 9%
Other 3 7%
Student > Postgraduate 3 7%
Other 8 18%
Unknown 9 20%
Readers by discipline Count As %
Medicine and Dentistry 21 47%
Immunology and Microbiology 3 7%
Social Sciences 2 4%
Nursing and Health Professions 2 4%
Pharmacology, Toxicology and Pharmaceutical Science 1 2%
Other 7 16%
Unknown 9 20%