Pancreatic adenocarcinoma-associated polymyositis treated with corticosteroids along with cancer specific treatment: case report

• Published in: BMC gastroenterology Vol. 11; no. 1; p. 33
• Main Authors: Syrios, John, Kechagias, Georgios, Xynos, Ioannis D, Gamaletsou, Maria N, Papageorgiou, Aristea, Agrogiannis, George, Tsavaris, Nicolas
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 07-04-2011; BioMed Central; BMC
• Subjects: Adenocarcinoma; Adenocarcinoma - diagnostic imaging; Adenocarcinoma - drug therapy; Adenocarcinoma - surgery; Antimetabolites, Antineoplastic - adverse effects; Antimetabolites, Antineoplastic - therapeutic use; Care and treatment; Case Report; Case studies; CD8-Positive T-Lymphocytes - drug effects; Complications and side effects; Corticosteroids; Deoxycytidine - adverse effects; Deoxycytidine - analogs & derivatives; Deoxycytidine - therapeutic use; Development and progression; Dosage and administration; Erlotinib Hydrochloride; Gemcitabine; Glucocorticoids - therapeutic use; Humans; Male; Middle Aged; Pancreatic cancer; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - drug therapy; Pancreatic Neoplasms - surgery; Polymyositis; Polymyositis - chemically induced; Polymyositis - drug therapy; Polymyositis - pathology; Quinazolines - therapeutic use; Radionuclide Imaging
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/1471-230X-11-33

Adenocarcinoma of the pancreas only rarely is associated with inflammatory myopathy. In this setting, polymyositis may be treated with glucocorticoids in combination with cancer specific treatment.
We present the case of a 52-year-old man with stage IIA pancreatic tail adenocarcinoma who underwent surgical treatment and six months into therapy with gemcitabine he developed symmetrical, painful, proximal muscle weakness with peripheral oedema. Re-evaluation with imaging modalities, muscle histology and biochemistry conferred the diagnosis of polymyositis associated with pancreatic cancer progression. The patient was treated with glucocorticoids along with gemcitabine and erlotinib which resulted in complete remission within six months. He remained in good health for a further six months on erlotinib maintenance therapy when a new computer tomography scan showed pancreatic cancer relapse and hence prompted 2nd line chemotherapy with gemcitabine.
Polymyositis associated with pancreatic cancer may respond to glucocorticoids along with cancer specific treatment.