Dermatomyositis as a risk factor of carcinogenesis- case report

Dermatomyositis (DM)
is an idiopathic inflammatory myopathy involving proximal muscle weakness and non-suppurative skeletal muscle inflammation

Epidemiology

To zdjęcie, autor: Nieznany autor, licencja: CC BY-SA
To zdjęcie, autor: Nieznany autor, licencja: CC BY-SA
2 to 3 : 1
Female-to-Male incidence ratio

The most commonly used criteria
1. Symmetric proximal muscle weakness
2. Elevated serum muscle enzymes
3. Myopathic changes in electromyography (EMG)
4. Characteristic muscle biopsy abnormalities
5. Typical rash

INCREASED RISK OF CANCER
Patients with DM must be monitored closely for potential malignancies, as there is an increased risk of cancer, particularly within the first 5 years after symptom onset
The most common cancers seen in patients with DM include
breast
colon
lung
ovarian
melanoma
non-Hodgkin lymphoma (NHL)
nasopharyngeal
stomach
The overall cancer rate in patients with DM varies between 9% and 32%.
The highest risk of developing cancer in patients with DM is within the first year
of onset of myositis
Dermatomyositis as a paraneoplastic syndrome may precede symptoms
and diagnosis of cancer or develop in advanced cancer process
Temporal Relation between the Diagnosis of Dermatomyositis and the Diagnosis of Cancer
https://www.nejm.org/doi/full/10.1056/nejm199202063260602

Screening

Case report
49 year old ,female patient diagnosed with DM in 2016
Early symptoms were:
rash on the face and eyelids,
Gottron sign,
proximal muscle weakness,
difficulties with deglutition and speech.
In the family: endometrial cancer (mother), digestive track cancer( 2 brothers)
The most commonly used criteria
1. Symmetric proximal muscle weakness
2. Elevated serum muscle enzymes
3. Myopathic changes in electromyography (EMG)
4. Characteristic muscle biopsy abnormalities
5. Typical rash

SKIN SYMPTOMS

TREATMENT
no long-term remission
excerebration of the disease
steroids iv in high doses

Course of a disease

ROMA +

Diagnostic laparoscopy
Increased CA-125 value

SEROUS FALOPIAN TUBE CANCER
DECISION ABOUT
COMPLETE REMOVAL OF REPRODUCTIVE ORGANS

CONCLUSION
Dermatomyositis can be a risk factor of carcinogenesis
It is important to pay attention to possibility of cancer development
Patients should be under careful medical supervision