皮肌炎是一种自身免疫性疾病,其特征是明显的皮肤和肌肉表现。皮肌炎的年发病率约为(5〜10)/100万人。值得注意的是,与普通人群相比,恶性肿瘤患者发生皮肌炎的风险较高.然而,在皮肌炎与恶性肿瘤同时发生的情况下,单纯激素治疗的疗效往往不理想.此外,关于肿瘤治疗和皮肌炎治疗之间相关性的报道很少.一名60岁的男性患者出现皮肌炎,最初表现为皮疹等症状,肌肉无力,和吞咽困难.尽管接受了标准激素治疗,皮肌炎症状无明显改善.考虑到病人伴随的麻烦咳嗽,进行了进一步调查,包括CT,PET-CT,和病理活检。这些评估证实了局限期小细胞肺癌(T1cN3M0IIIB)的诊断。值得注意的是,在这个病人身上,皮肌炎被怀疑是与小细胞肺癌相关的副肿瘤综合征。采用标准化疗和放疗治疗小细胞肺癌,导致两个治疗周期后部分缓解。随着恶性肿瘤的消退,观察到皮肌炎症状显着改善,随后导致处方激素剂量逐渐减少。总之,在整个治疗过程中,我们对皮肌炎作为副肿瘤综合征进行了全面的案例研究。对肿瘤治疗的反应与皮肌炎症状的改善相吻合。因此,对于诊断为皮肌炎的患者,必须进行勤奋的恶性肿瘤筛查。
Dermatomyositis represents an autoimmune disorder characterized by notable skin and muscular manifestations. The annual incidence of dermatomyositis stands at approximately (5~10)/1 million individuals. Notably, patients with malignant tumors exhibit an elevated risk of developing dermatomyositis compared to the general population. However, in cases where dermatomyositis co-occurs with malignancy, the efficacy of hormone therapy alone tends to be suboptimal. Moreover,
reports addressing the correlation between tumor treatment and the management of dermatomyositis are scarce. A 60-year-old male patient presented with dermatomyositis, initially manifesting through symptoms such as rash, muscle weakness, and dysphagia. Despite undergoing standard hormone therapy, there was no discernible improvement in the dermatomyositis symptoms. Considering the patient\'s concomitant troublesome cough, further investigations were conducted, including CT, PET-CT, and pathological biopsy. These assessments confirmed the diagnosis of limited-stage small cell lung cancer (T1cN3M0 IIIB). Notably, in this patient, dermatomyositis was suspected to be a paraneoplastic syndrome associated with small cell lung cancer. Standard chemotherapy and radiotherapy were employed to treat the small cell lung cancer, resulting in partial remission after two treatment cycles. As the malignancy regressed, a notable improvement in dermatomyositis symptoms was observed, subsequently leading to a gradual reduction in the prescribed hormone dosage. In conclusion, we present a comprehensive
case study of dermatomyositis as a paraneoplastic syndrome throughout the treatment process. The response to tumor therapy coincided with the amelioration of dermatomyositis symptoms. Therefore, diligent malignancy screening is imperative for patients diagnosed with dermatomyositis.