Paraneoplastic myopathy in pancreatic cancer: a case report and literature review

Figures & data

Table 1. Cases of pancreatic carcinoma associated polymyositis and myopathy

Case	Kida et al.[^20]	Syrios et al.[^15]	Siddiqui et al.[^21]	Amroun et al.[^22]	Padniewski et al., present case
Publication year	2007	2011	2011	2012	2020
Cancer type	pancreatic adenocarcinoma	pancreatic adenocarcinoma	invasive papillary adenocarcinoma	infiltrating ductal pancreatic adenocarcinoma	pancreatiadenocarcinoma
Diagnostic tools	CPK and biopsy	CPK, electromyography and biopsy	CPK and biopsy	CPK and biopsy	CPK, MRI, no confirmatory biopsy performed, presumed polymyositis unable to be confirmed
Gemcitabine use	No	Yes	No	Yes	Yes, later in course
Management	Prednisolone, fluorouracil, radiotherapy	Glucocorticoids, gemcitabine, erlotinib	Prednisone, surgical resection	Surgical resection, gemcitabine	Prednisone, FOLFOX followed by gemcitabine
Additional findings	Late-stage carcinoma	-	-	Myopathy developed during 4th cycle of chemo	Myopathy developed prior to gemcitabine
Outcome	Died 4 years after diagnosis	Remission for 6 months, then relapse	Remission	Remission	Gemcitabine trial, death 1 month later

Figure 1. MRI of patient’s lumbar spine. T2 image with solid arrows showing edema of paraspinal muscles. Outlined arrows indicated psoas muscles, which are non-edematous

Figure 2. MRI of patient’s lumbar spine. T1 with contrast image with arrows indicating areas of enhancement in lumbar paraspinal muscles

Kida Y, Maeshima E, Furukawa K, et al. A case of polymyositis with a significantly high level of KL-6 associated with pancreatic cancer. Mod Rheumatol. 2007;17(3):262–264.

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Syrios J, Kechagias G, Xynos ID, et al. Pancreatic adenocarcinoma-associated polymyositis treated with corticosteroids along with cancer specific treatment: case report. BMC Gastroenterol. 2011;11:33.

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Siddiqui S, Fiorillo M, Tzeng J, et al. Polymyositis as a paraneoplastic phenomenon of occult pancreatic cancer. Am J Gastroenterol. 2011;106:S220.

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Amroun KL, De Mestier L, Deguelte-Lardiere S, et al. Pancreas cancer-associated polymyositis of the legs regressing after cephalic duodenopancreatectomy: case report and review of the literature. JOP. 2012;13(6):674–676.

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