Journal of Diagnostics Concepts & Practice >
Eleven cases of dermatomyositis accompanied with gynecological malignant tumor: clinical characteristics and short-term follow-up
Received date: 2020-12-20
Online published: 2022-06-28
Objective: To analyze the clinical characteristics, diagnosis and treatment of dermatomyositis (DM) accompanied with gynecological malignant tumor to provide evidence for early detection and intervention of the disease. Methods: The clinical data of 11 DM patients with gynecological malignant tumor treated in our hospital from 2015 to 2020 were enrolled, and the clinical characteristics and treatment protocols were analyzed. Results: In eleven patients diagnosed DM accompanied with gynecological malignant tumor, three types of cancer were identified, including endometrial cancer (4/11), cervical cancer (2/11), and ovarian cancer (5/11). Eightout of 11 patients were diagnosed stage Ⅲ-Ⅳ gynecological cancer according to 2020 FIGO(International Federation of Gynecology and Obstetrics) gynecological tumor staging. Ten patients were screened for gynecological cancer by imaging and tumor biomarkers,and diagnosed gynecological cancer after being confirmed as DM 1 week to 21 months. The other one patient was found to have ovarian cancer at 21st month after diagnosis of DM because of the increased level of CA12-5 (carbohydrate antigen12-5) during the follow-up, however, her CT imaging of the pelvic and abdominal cavity and tumor biomarkers were normal in initial screening. The anti-TIF1-γ antibodies in 8 DM patients were tested, and 6 of them were positive. Except one patient with cervical cancer receiving directly radical radiotherapy and chemotherapy, the other 10 patients received gynecological tumor resection. The overall survival rate was 100% during the follow-up of 2 months to 2 years. There was no tumor recurrence duringthe follow-up, but the DM recurrence appeared in 2patients. Conclusions: For the DM patients lacking signs of malignant tumor in the initial screening, the continuing follow-upand screening for tumor biomarkers should get more attention.The DM patients accompanied gynecological malignant tumor often showed late-stage cancer (Ⅲ-Ⅳ staging) and the treatment should be mainly focused on the gynecological tumor.
Key words: Dermatomyositis; Gynecological malignancy; Cancer antigen12-5
LIU Chang, CAO Hua, FENG Weiwei, SHEN Lifei . Eleven cases of dermatomyositis accompanied with gynecological malignant tumor: clinical characteristics and short-term follow-up[J]. Journal of Diagnostics Concepts & Practice, 2021 , 20(01) : 53 -59 . DOI: 10.16150/j.1671-2870.2021.01.008
[1] | 中华医学会风湿病学分会. 多发性肌炎和皮肌炎诊断及治疗指南[J]. 中华风湿病学杂志, 2010, 14(12):828-831. |
[2] | Barnes BE, Mawr B. Dermatomyositis and malignancy. A review of the literature[J]. Ann Intern Med, 1976, 84(1):68-76. |
[3] | Aussy A, Boyer O, Cordel N. Dermatomyositis and immune-mediated necrotizing myopathies: a window on autoimmunity and cancer[J]. Front Immunol, 2017, 8:992. |
[4] | Pinal-Fernandez I, Ferrer-Fabregas B, Trallero-Araguas E, et al. Tumour TIF1 mutations and loss of heterozygosity related to cancer-associated myositis[J]. Rheumatology (Oxford), 2018, 57(2):388-396. |
[5] | Nikolaos T, Maria T, Ioannis KD, et al. Dermatomyositis as an early manifestation and a significant clinical precursor of lung cancer: report of a rare case and review of the current literature[J]. Int J Clin Exp Med, 2013, 6(2):105-109. |
[6] | Dalmau J, Graus F, Rosenblum MK, et al. Anti-Hu--associated paraneoplastic encephalomyelitis/sensory neuronopathy. A clinical study of 71 patients[J]. Medicine (Baltimore), 1992, 71(2):59-72. |
[7] | Peterson K, Rosenblum MK, Kotanides H, et al. Paraneoplastic cerebellar degeneration. I. A clinical analysis of 55 anti-Yo antibody-positive patients[J]. Neurology, 1992, 42(10):1931-1937. |
[8] | Casciola-Rosen L, Nagaraju K, Plotz P, et al. Enhanced autoantigen expression in regenerating muscle cells in idiopathic inflammatory myopathy[J]. J Exp Med, 2005, 201(4):591-601. |
[9] | Levine SM. Cancer and myositis: new insights into an old association[J]. Curr Opin Rheumatol, 2006, 18(6):620-624. |
[10] | Kim Y, Song KS, Sohn EH, et al. Anti-TIF1γ antibody and the expression of TIF1γ in idiopathic inflammatory myopathies[J]. Int J Rheum Dis, 2019, 22(2):314-320. |
[11] | Scholtissek B, Ferring-Schmitt S, Maier J, et al. Expression of the autoantigen TRIM33/TIF1γ in skin and muscle of patients with dermatomyositis is upregulated, together with markers of cellular stress[J]. Clin Exp Dermatol, 2017, 42(6):659-662. |
[12] | 赵辨. 中国临床皮肤病学[M]. 南京: 江苏科学技术出版社, 2010:807-814. |
[13] | de Souza FH, Shinjo SK. Newly diagnosed dermatomyositis in the elderly as predictor of malignancy[J]. Rev Bras Reumatol, 2012, 52(5):713-721. |
[14] | Buchbinder R, Forbes A, Hall S, et al. Incidence of malignant disease in biopsy-proven inflammatory myopathy. A population-based cohort study[J]. Ann Intern Med, 2001, 134(12):1087-1095. |
[15] | Hill CL, Zhang Y, Sigurgeirsson B, et al. Frequency of specific cancer types in dermatomyositis and polymyositis: a population-based study[J]. Lancet, 2001, 357(9250):96-100. |
[16] | 夏群力, 刁立诚, 吴海曦, 等. 抗转录中介因子1-γ抗体是成人皮肌炎合并恶性肿瘤的血清学标志物[J]. 诊断学理论与实践, 2020, 19(3):274-278. |
[17] | 赵培珠, 李玉叶. 多发性肌炎/皮肌炎伴发恶性肿瘤的治疗[J]. 中国临床医生杂志, 2016, 44(77):8-10. |
[18] | 钟宗良, 莫浩元, 麦海强, 等. 初治鼻咽癌合并皮肌炎86例临床配对研究[J]. 中国肿瘤, 2012, 21(3):220-224. |
/
〈 |
|
〉 |