ABSTRACT
The association between dermatomyositis (DM) and cancer has been well recognized; so that cancer can be diagnosed before, or more likely simultaneously with and after the diagnosis of DM. Its coexistence with nasopharyngeal cancer is relatively rare in Caucasian populations. Here we report a young patient who had a diagnosis of nasopharyngeal cancer in remission and presented with progressive muscle weakness without any skin manifestation. DM diagnosis was confirmed with muscle histopathology. Paraneoplastic DM could develop during cancer, even in remission, by an immune reaction to antigens expressed in both cancer cells and regenerating fibers in affected muscle and/or skin.
References
1
Zahr ZA, Baer AN. Malignancy in myositis. Curr Rheumatol Rep 2011;13:208-15.
2
Hill CL, Zhang Y, Sigurgeirsson B, et al. Frequency of specific cancer types in dermatomyositis and polymyositis: a population-based study. Lancet 2001;357:96-100.
3
Huang YL, Chen YJ, Lin MW, et al. Malignancies associated with dermatomyositis and polymyositis in Taiwan: a nationwide population-based study. Br J Dermatol 2009;161:854-60.
4
Zhang W, Jiang SP, Huang L. Dermatomyositis and malignancy: a retrospective study of 115 cases. Eur Rev Med Pharmacol Sci 2009;13:77-80.
5
Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med 1975;292:344-7.
6
Bohan A, Peter JB. Polymyositis and dermatomyositis (second of two parts). N Engl J Med 1975;292:403-7.
7
Szwebel TA, Perrot S, Kierzek G, et al. Paraneoplasic dermatomyositis sine dermatitis associated with a tumor of the renal excretion system. J Clin Neuromuscul Dis 2008;10:35-6.
8
Park JS, Park JY. Dermatomyositis sine dermatitis, a rare phenotype of idiopathic inflammatory myopathy. Yeungnam Univ J Med 2017;34:137-9.
9
Nilipour Y, Ghiasi M, Rohani M, Omrani F. Juvenile dermatomyositis without skin lesions. Iran J Neurol 2015;14:171-3.
10
Aussy A, Boyer O, Cordel N. Dermatomyositis and immune-mediated necrotizing myopathies: a window on autoimmunity and cancer. Front Immunol 2017;8:992.
11
Owada T, Maezawa R, Kurasawa K, Okada H, Arai S, Fukuda T. Detection of inflammatory lesions by f-18 fluorodeoxyglucose positron emission tomography in patients with polymyositis and dermatomyositis. J Rheumatol 2012;39:1659-65.
12
Tateyama M, Fujihara K, Misu T, Arai A, Kaneta T, Aoki M. Clinical values of FDG PET in polymyositis and dermatomyositis syndromes: imaging of skeletal muscle inflammation. BMJ Open 2015;5:e006763.
13
Liu Y, Xu L, Wu H, et al. Characteristics and predictors of malignancy in dermatomyositis: Analysis of 239 patients from northern China. Oncol Lett 2018;16:5960-8.
14
Huang PY, Zhong ZL, Luo DH, et al. Paired study of 172 cases of nasopharyngeal carcinoma with or without dermatomyositis. Acta Otolaryngol 2014;134:824-30.
15
Casciola-Rosen L, Nagaraju K, Plotz P, et al. Enhanced autoantigen expression in regenerating muscle cells in idiopathic inflammatory myopathy. J Exp Med 2005;201:591-601.
16
Zampieri S, Valente M, Adami N, et al. Polymyositis, dermatomyositis and malignancy: a further intriguing link. Autoimmun Rev 2010;9:449-53.