Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Occult breast cancer is defined by the presence of axillary metastases without an identifiable primary breast tumor. Here, we report a rare case of a male occult breast cancer with dermatomyositis. We performed a modified radical mastectomy consisting of whole breast mastectomy and axillary lymph node dissection. Immunohistochemistry and fluorescent in situ hybridization analyses demonstrated an adenocarcinoma likely of breast origin, which was an occult triple-negative breast cancer. Interestingly, the patient's previously noted periorbital dermatomyositis resolved promptly following surgical excision.
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PMID:Male occult triple-negative breast cancer with dermatomyositis: a case report and review of the literature. 2918 Aug 79

Breast cancer in male is rare which accounts about 1% of all malignant breast neoplasm cases. Since paraneoplastic syndrome is unusual with male breast cancer, very few reported cases are found. A72- year-old gentleman presented with proximal myopathy in all four limbs was referred to Dr. Sirajul Islam Medical College and Hospital in April 2017. He had generalized wasting with reduced tone and reflexes. Planter responses were normal with intact sensory. There were typical Heliotrope rash bilaterally. In background, he had history of radical mastectomy due to stage IIA ductal carcinoma of left breast 7 years back. Three years later, he was found to have multiple metastases in lung and liver, however, deliberately discontinued chemotherapy after first dose. Currently he is on Tamoxifen. Two months back, he was diagnosed to have brain metastasis. Also his serum sodium level was low with low urine osmolality. Considering his background, we diagnosed him dermatomyositis with peripheal neuropathy & SIADH as paraneoplastic presentation of breast malignancy. Despite of normal CPK and NCV, we treated him with steroid as dermatomyositis can present with normal CPK. His myopathy improved after 2 weeks of steroid treatment. Fluid restriction increased his serum sodium level. The aim of reporting this case is to aware physicians about the aggressive nature of male breast cancer, its orthodox paraneoplastic presentation and to differentiate neuropathy from myopathy so that early treatment can improve the outcome.
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PMID:Breast Cancer with Paraneoplastic Syndrome in a 72 Year Old Male Patient. 3075 79

Checkpoint inhibitor immunotherapy is a transformative treatment for advanced malignancies, but can be associated with numerous immune-related adverse events (irAEs). The majority of irAEs include those that closely resemble known cutaneous and neurocutaneous autoimmune or autoinflammatory diseases, such as scleroderma, psoriasis, and dermatomyositis. We present the case of a 63-year-old man with metastatic melanoma undergoing treatment with nivolumab who developed significant motor weakness, paresthesias of both hands, swollen fingers, and a pruritic rash over the face, chest, and upper back after two cycles. Creatine kinase was elevated. Electromyography revealed a myopathic pattern, muscle biopsy of the deltoid revealed an inflammatory myopathy, and skin biopsy showed interface dermatitis. There were no detectable autoantibodies except positive antinuclear antibody. He was diagnosed with immunotherapy-induced dermatomyositis, nivolumab was held, and he was treated with oral prednisone and intravenous immunoglobulin with overall improvement in myopathic and cutaneous symptoms. Dermatomyositis is an inflammatory myopathy with a characteristic dermatologic presentation that can occur spontaneously, as a paraneoplastic phenomenon, or as a drug reaction. This is the second known case of nivolumab-induced dermatomyositis. A review of the literature revealed seven total cases of immunotherapy-induced dermatomyositis. Functionally disabling autoimmune adverse effects of this severity would frequently persuade providers to discontinue immunotherapy in patients with metastatic disease.
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PMID:Dermatomyositis in a patient undergoing nivolumab therapy for metastatic melanoma: a case report and review of the literature. 3156 90


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