scholarly journals Paraneoplastic dermatomyositis and prostate cancer: myopathy regression under cancer-directed therapy

2021 ◽  
Author(s):  
Mafalda Miranda Baleiras ◽  
Luís Maduro ◽  
Carolina Vasques ◽  
Filipa Ferreira ◽  
Marta Mesquita Pinto ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Paraneoplastic Syndrome ◽  
Inflammatory Myopathy ◽  
Idiopathic Inflammatory Myopathy ◽  
Prostate Adenocarcinoma ◽  
Unknown Etiology ◽  
Erythematous Rash ◽  
Severe Dysphagia ◽  
Underlying Malignancy ◽  
Systemic Disorder

Prostate cancer is the second most frequent malignancy in men worldwide and the fifth leading cause of death. Dermatomyositis (DM) is a rare idiopathic inflammatory myopathy characterized by musculocutaneous manifestations. However, DM can also present as a paraneoplastic syndrome of an underlying neoplasm. We report a case of a 65-year-old man diagnosed with prostate adenocarcinoma in the setting of severe dysphagia, muscle weakness and a facial erythematous rash. At first, the DM-related symptoms resolved with the initial treatment for the underlying malignancy. Yet, they flared up as the tumor progressed. To sum up, DM is a rare systemic disorder with unknown etiology. There is a well-established association between DM and malignancy. Malignancy-headed therapy can improve DM manifestations and the recurrence of DM symptoms may act as an early warning of malignancy relapse.

scholarly journals ANTISYNTHETASE SYNDROME AND THE POSITION OF CLINICAL IMMUNOLOGIST

2020 ◽  
pp. 66-71
Author(s):  
Валентина Чоп’як ◽  
Христина Ліщук-Якимович ◽  
Роман Пукаляк ◽  
Омелян Синенький
Keyword(s):  
Clinical Case ◽  
Inflammatory Myopathy ◽  
Idiopathic Inflammatory Myopathy ◽  
Pulse Therapy ◽  
Lung Damage ◽  
Aged Patient ◽  
Antisynthetase Syndrome ◽  
Erythematous Rash ◽  
Fibrosing Alveolitis ◽  
High Doses

Antisynthetase syndrome is a clinical and laboratory syndrome that develops in patients with idiopathic inflammatory myopathy and is characterized by the development of interstitial lung disease, namely fibrosing alveolitis syndrome, resistance to traditional corticoid therapy and the presence of myositis-specific antibodies.We present a clinical case of an antisynthetase syndrome in a middle-aged patient who has presented severe myalgic syndrome, photodermatosis, Raynaud’s phenomenon. The disease debuted with cutaneous (heliotropic erythema, erythematous rash on the skin of the upper torso) and myalgic symptoms, fever with next adding of the joint syndrome, as well as lung damage (pulmonitis and infiltrates). Immunological testing revealed anti-Jo-1, anti-PL-12-, anti-PL-7 antibodies («Polycheck», BIOCHECK, Germany). Since years, the patient has got the diagnosis of antisynthetase syndrome. The use of combined pulse therapy with cyclophosphamide and methylprednisolone, as well as the addition of high doses of vitamin D3 has contributed to the regression oflung damage and reduction of dermatomyositis activity.

scholarly journals Metastatic prostate cancer presenting as tumour-induced osteomalacia

2019 ◽  
Vol 12 (7) ◽  
pp. e229434
Author(s):  
Awo Akosua K Layman ◽  
Shivam Joshi ◽  
Sanjeev Shah
Keyword(s):  
Prostate Cancer ◽  
Lower Extremity ◽  
Parotid Gland ◽  
Basal Cell ◽  
Paraneoplastic Syndrome ◽  
Bone Pain ◽  
Metastatic Prostate Cancer ◽  
Prostate Adenocarcinoma ◽  
Malignant Tumours ◽  
Oncogenic Osteomalacia

Tumour-induced osteomalacia (TIO), or oncogenic osteomalacia, is a paraneoplastic syndrome marked by hypophosphataemia, renal phosphate wasting, bone pain, weakness, and fractures. The syndrome has been reported with both benign and malignant tumours including parotid gland basal cell tumours, thyroid carcinomas, colon adenocarcinomas, and prostate cancer. Often, the syndrome is marked by an insidious course during which patients present with generalised bony pain and weakness, which do not resolve until the underlying tumour is identified and treated. We present a case of a patient with Parkinson’s disease whose subacute weakness, lower extremity paresis, and renal phosphate wasting led to the synchronous diagnosis of metastatic prostate adenocarcinoma and TIO.

scholarly journals Dermatomyositis associated with prostate adenocarcinoma with neuroendocrine differentiation

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hideyuki Minagawa ◽  
Taketo Kawai ◽  
Akihiko Matsumoto ◽  
Katsuhiro Makino ◽  
Yusuke Sato ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Progression ◽  
Rare Case ◽  
Neuroendocrine Differentiation ◽  
Oral Intake ◽  
Prostate Adenocarcinoma ◽  
High Dose ◽  
Case Presentation ◽  
Severe Dysphagia ◽  
Multiple Metastases

Abstract Background Although it is known that malignancies can be associated with dermatomyositis, there are few reports on dermatomyositis associated with prostate cancer with neuroendocrine differentiation. Case presentation A 63-year-old man visited our hospital due to pollakiuria. High levels of PSA and NSE were observed, and prostate biopsy revealed an adenocarcinoma with neuroendocrine differentiation. Multiple metastases to the lymph nodes, bones, and liver were identified, and androgen deprivation therapy (ADT) was started immediately. Following 2 weeks of treatment, erythema on the skin, and muscle weakness with severe dysphagia appeared. The patient was diagnosed with dermatomyositis, and high-dose glucocorticoid therapy was initiated. ADT and subsequent chemotherapy with etoposide and cisplatin (EP) were performed for prostate cancer, which resulted in decreased PSA and NSE and reduction of all metastases. After the initiation of EP therapy, dermatomyositis improved, and the patient regained oral intake function. Although EP therapy was replaced by docetaxel, abiraterone, and enzalutamide because of adverse events, no cancer progression was consistently observed. Dermatomyositis worsened temporarily during the administration of abiraterone, but it improved upon switching from abiraterone to enzalutamide and dose escalation of glucocorticoid. Conclusions We successfully treated a rare case of dermatomyositis associated with prostate adenocarcinoma with neuroendocrine differentiation.

scholarly journals Metastatic Prostate Cancer Manifesting as Cholestatic Jaundice: A Case Report and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Deepak Ravindranathan ◽  
Emilie Elise Hitron ◽  
Greta Anne Russler ◽  
Yue Xue ◽  
Mehmet Asim Bilen
Keyword(s):  
Prostate Cancer ◽  
Case Report ◽  
Androgen Deprivation Therapy ◽  
Paraneoplastic Syndrome ◽  
Metastatic Prostate Cancer ◽  
Androgen Deprivation ◽  
Cholestatic Jaundice ◽  
Newly Diagnosed ◽  
Review Of The Literature ◽  
Underlying Malignancy

A paraneoplastic syndrome can often present as the first manifestation of an underlying malignancy. We report a patient who presented with cholestatic jaundice as a paraneoplastic syndrome from his newly diagnosed metastatic prostate cancer. He received initial treatment with androgen deprivation therapy followed by six cycles of docetaxel resulting in resolution of his cholestatic process, normalization of liver enzyme levels, and excellent biochemical and radiographic response. To the best of our knowledge, this is the first reported case of metastatic prostate cancer with cholestatic jaundice as a paraneoplastic phenomenon to be safely treated with androgen deprivation therapy and upfront docetaxel, reflecting the latest shift in the treatment of metastatic prostate cancer.

scholarly journals T1 mapping-derived signature of myocardial involvement in idiopathic inflammatory myopathy compared to acute viral myocarditis: a texture-based analysis

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
E Bollache ◽  
AT Huber ◽  
J Lamy ◽  
E Afari ◽  
TM Bacoyannis ◽  
...  
Keyword(s):  
Contrast Agent ◽  
Texture Analysis ◽  
T1 Mapping ◽  
Inflammatory Myopathy ◽  
Viral Myocarditis ◽  
Texture Features ◽  
Idiopathic Inflammatory Myopathy ◽  
Post Contrast ◽  
Myocardial T1 ◽  
Myocardial Involvement

Abstract Funding Acknowledgements Type of funding sources: None. Background. Recent studies revealed the ability of MRI T1 mapping to characterize myocardial involvement in both idiopathic inflammatory myopathy (IIM) and acute viral myocarditis (AVM), as compared to healthy controls. However, neither myocardial T1 nor T2 maps were able to discriminate between IIM and AVM patients, when considering conventional myocardial mean values and derived indices such as lambda and extracellular volume. Purpose. To investigate the ability of T1 mapping-derived texture analysis to differentiate IIM from AVM. Methods. Forty patients, 20 with IIM (51 ± 17 years, 9 men) and 20 with AVM (34 ± 13 years, 16 men) underwent 1.5T MRI T1 mapping using a modified Look-Locker inversion-recovery sequence before and 15 minutes after injection of a gadolinium contrast agent. After manual delineation of endocardial and epicardial borders and co-registration of all inversion time images, native and post-contrast T1 maps were estimated. Myocardial texture analysis was performed on native T1 maps. Textural features such as: autocorrelation, contrast, dissimilarity, energy and sum entropy were used to build a least squares-based linear regression model. Finally, receiver operating characteristic (ROC) analysis was used to investigate the ability of such texture features score to classify IIM vs. AVM patients, compared to the performance of mean myocardial T1. A Wilcoxon rank-sum test was also used to test difference significance between groups. Results. Both native and post-contrast mean myocardial T1 values were comparable between IIM (native: 1022 ± 43 ms; post-contrast: 319 ± 44 ms) and AVM (1056 ± 59 ms, p = 0.07; 318 ± 35 ms, p = 0.90, respectively) groups. Results of ROC analyses are provided in the Table, indicating that a better discrimination between IIM and AVM patients was obtained when using texture features, with higher AUC and accuracy than mean T1 values (Figure). Conclusion. Texture analysis derived from MRI T1 maps without contrast agent injection was able to discriminate between IIM and AVM with higher accuracy, sensitivity and specificity than conventional T1 indices. Such analysis could provide a useful myocardial signature to help diagnose and manage cardiac alterations associated with IIM in patients presenting with myocarditis and primarily suspected of AVM. Table Area under curve (AUC) Accuracy Sensitivity Specificity Native T1 0.67 0.70 0.65 0.75 Post-contrast T1 0.49 0.60 0.25 0.95 Texture features score 0.85 0.82 0.90 0.75 ROC analyses for classification between IIM and AVM patients Abstract Figure

scholarly journals Cerebrospinal Fluid Rhinorrhea as the First Symptom of Metastatic Prostate Adenocarcinoma

2021 ◽  
pp. 014556132110167
Author(s):  
Magdalena Ostrowska ◽  
Maciej J. Wróbel
Keyword(s):  
Prostate Cancer ◽  
Cerebrospinal Fluid ◽  
Paranasal Sinuses ◽  
Cancer Metastasis ◽  
Treatment Strategies ◽  
Prostate Adenocarcinoma ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Csf Leakage ◽  
Prostate Cancer Metastasis ◽  
Csf Rhinorrhoea

The most common cause of cerebrospinal fluid (CSF) rhinorrhoea is damage to the skull base with a dura mater’s rupture due to an accident or an iatrogenic injury. This applies to over 96% of cases. Other possibilities that can lead to CSF leakage are neoplasms of the nasal cavity, paranasal sinuses, and nasopharynx. Although prostate cancer spreads to bones, cranial metastases to paranasal sinuses are extremely rare. We present a case of an 83-year-old patient with CSF leakage due to infiltrating metastatic prostate cancer. Cerebrospinal fluid rhinorrhea turned out to be the first symptom of prostate cancer metastasis. Diagnostic and treatment strategies are presented in the discussion.

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