학술논문
Paraneoplastic myopathy-related rhabdomyolysis and pancreatic cancer: A case report and review of the literature.
Document Type
Report
Author
Costantini A; Department of Surgical, Oncological and Gastroenterological Sciences, UOC Chirurgia Generale 1, University of Padua, Padua 35128, Italy.; Moletta L; Department of Surgical, Oncological and Gastroenterological Sciences, UOC Chirurgia Generale 1, University of Padua, Padua 35128, Italy. lucia.moletta@unipd.it.; Pierobon ES; Department of Surgical, Oncological and Gastroenterological Sciences, UOC Chirurgia Generale 1, University of Padua, Padua 35128, Italy.; Serafini S; Department of Surgical, Oncological and Gastroenterological Sciences, UOC Chirurgia Generale 2, University of Padua, Padua 35128, Italy.; Valmasoni M; Department of Surgical, Oncological and Gastroenterological Sciences, UOC Chirurgia Generale 1, University of Padua, Padua 35128, Italy.; Sperti C; Department of Surgical, Oncological and Gastroenterological Sciences, UOC Chirurgia Generale 2, University of Padua, Padua 35128, Italy.
Source
Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 101618806 Publication Model: Print Cited Medium: Print ISSN: 2307-8960 (Print) Linking ISSN: 23078960 NLM ISO Abbreviation: World J Clin Cases Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2307-8960
Abstract
Background: Rhabdomyolysis is a life-threatening condition, often leading to progressive renal failure and death. It is caused by destruction of skeletal muscle and the release of myoglobin and other intracellular contents into the circulation. The most frequent cause of this condition is "crush syndrome", although several others have been described and paraneoplastic inflammatory myopathies associated with various types of cancer are repeatedly reported.
Case Summary: We describe a rare case of a patient with pancreatic cancer who developed rhabdomyolysis early on, possibly due to paraneoplastic myositis leading to acute renal failure and eventually to rapid death. A 78-year-old Caucasian woman was referred to our hospital for obstructive jaundice and weight loss due to a lesion in the pancreatic head. She presented increasingly severe renal insufficiency with anuria, a dramatic increase in creatine phosphokinase (36000 U/L, n.v. 20-180 U/L) and myoglobin (> 120000 μg/L, n.v. 12-70 μg/L). On clinical examination, the patient showed increasing pain in the lower limbs associated with muscle weakness which was severe enough to immobilize her. Paraneoplastic myopathy linked to the malignant lesion of the pancreatic head was suspected. The patient was treated with hemodialysis and intravenous methylprednisolone. Despite all the efforts to prepare the patient for surgery, her general condition rapidly deteriorated and she eventually died 30 d after hospital admission.
Conclusion: The possible causes of rhabdomyolysis in this patient with pancreatic cancer are discussed, the development of paraneoplastic myopathy being the most likely. Clinicians should bear in mind that these syndromes may become clinically manifest at any stage of the cancer course and their early diagnosis and treatment could improve the patient's prognosis.
Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest.
(©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)
Case Summary: We describe a rare case of a patient with pancreatic cancer who developed rhabdomyolysis early on, possibly due to paraneoplastic myositis leading to acute renal failure and eventually to rapid death. A 78-year-old Caucasian woman was referred to our hospital for obstructive jaundice and weight loss due to a lesion in the pancreatic head. She presented increasingly severe renal insufficiency with anuria, a dramatic increase in creatine phosphokinase (36000 U/L, n.v. 20-180 U/L) and myoglobin (> 120000 μg/L, n.v. 12-70 μg/L). On clinical examination, the patient showed increasing pain in the lower limbs associated with muscle weakness which was severe enough to immobilize her. Paraneoplastic myopathy linked to the malignant lesion of the pancreatic head was suspected. The patient was treated with hemodialysis and intravenous methylprednisolone. Despite all the efforts to prepare the patient for surgery, her general condition rapidly deteriorated and she eventually died 30 d after hospital admission.
Conclusion: The possible causes of rhabdomyolysis in this patient with pancreatic cancer are discussed, the development of paraneoplastic myopathy being the most likely. Clinicians should bear in mind that these syndromes may become clinically manifest at any stage of the cancer course and their early diagnosis and treatment could improve the patient's prognosis.
Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest.
(©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)