攝護腺癌相關皮肌炎之病例報告

謝棨圳¹、 李經家^1,2,3

¹高雄醫學大學附設中和紀念醫院泌尿部

²高雄醫學大學醫學院臨床醫學研究所

³高雄醫學大學醫學院醫學系泌尿學科

Prostate Cancer Related Dermatomyositis: A Case Report

Chi-Chun Hsieh¹, Ching‑Chia Li^1,2,3

¹Department of Urology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan

²Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical

University, Kaohsiung, Taiwan

³Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

Abstract

Background

Dermatomyositis is a rare disease with idiopathic inflammatory myopathy. Dermatomyositis is also related to malignancy sometimes, which was so called paraneoplastic syndrome. We report a case diagnosed as prostate cancer after cutaneous manifestation of dermatomyositis.

Cases Presentation

A 69-year-old male with past history of asthma, major depressive disorder and enlarged prostate. Bilateral renal stones were noted accidentally. Itching erythematous plaques over trunk, scalp and four limbs for 4-5 months. Also, progressive skin lesion was found and heliotrope sign, shawl sign, V-sign, and Gottron's sign were suspected. Autoimmune profiles were check and result showed elevated TIF1 gamma (Transcriptional intermediary factor), indicated paraneoplastic dermatomyositis. Cancer survey showed elevated PSA and he was diagnosed as prostate cancer after biopsy. He received robotic assisted radical prostatectomy + bilateral pelvic lymph node dissection and dermatomyositis subsided months after the operation.

Conclusion

Paraneoplastic dermatomyositis is one of possible hint for diagnosis of malignancy. Treat the cancer itself may improve progression of dermatomyositis instead of use symptom-relieving medication. Keep monitoring symptoms of dermatomyositis may also be helpful for cancer follow-up.