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Polymyositis associated with urinary bladder cancer: an autopsy case
Isao Takeda1, Kota Sugisaki, Haruyo Iwadate
1Division of Rheumatology, Ohta Nishinouchi Hospital, Koriyama City, Japan.
Fukushima Journal of Medical Science
|November 13, 2004
Summary
A man with muscle weakness and elevated creatine kinase, initially diagnosed with polymyositis, developed anuria and died from respiratory insufficiency. Autopsy revealed urinary bladder cancer with liver metastasis and lung lymphangitis.
Area of Science:
- Oncology
- Nephrology
- Rheumatology
Background:
- A 56-year-old male presented with muscle weakness and elevated serum creatine kinase.
- Initial diagnosis was polymyositis, treated with corticosteroids, methotrexate, and cyclosporin A.
Observation:
- The patient developed anuria 11 months after symptom onset, requiring hemodialysis.
- Respiratory insufficiency led to death 14 months after initial muscle weakness symptoms.
Findings:
- Autopsy revealed urinary bladder cancer, specifically adenosquamous cell carcinoma.
- Metastatic liver disease and cancerous lymphangitis of the lung were also identified.
Implications:
- This case highlights a potential, albeit rare, association between polymyositis-like symptoms and underlying malignancy.
- It underscores the importance of considering non-inflammatory causes in refractory or atypical presentations of myositis.
- The findings suggest a need for thorough oncological screening in patients with unexplained myopathy and systemic symptoms.