Миозит, ассоциированный со злокачественными опухолями

Идиопатические воспалительные миопатии (ИВМ) – гетерогенная группа приобретенных системных заболеваний с преимущественным поражением скелетной мускулатуры. Основными представителями ИВМ являются полимиозит (ПМ) и дерматомиозит (ДМ). Эпидемиологические исследования демонстрируют взаимосвязь между ПМ/ДМ и злокачественными новообразованиями (ЗН), риск выявления которых выше, чем в популяции соответствующих возрастных групп. Частота ЗН при ПМ/ДМ колеблется в диапазоне от 9 до 50%. Связь со ЗН описана при каждом подтипе ИВМ, однако наиболее часто они выявляются при ДМ. Пациенты, страдающие ПМ/ДМ, ассоциированным со ЗН, имеют худший прогноз, чем больные ЗН. Раннее выявление ЗН позволило бы улучшить прогноз у этих больных. Опубликованные исследования выделяют демографические, клинические и лабораторные факторы, повышающие риск выявления ЗН у пациентов с ПМ/ДМ. Тем не менее все они охватывают небольшие группы больных, полученные результаты неоднородны и не вполне убедительны, что требует дальнейшего, более масштабного, изучения этой проблемы.

Цель исследования – выявление и идентификация особенностей паранеопластического миозита (ПнМ).

Материал и методы. В исследование включены 320 пациентов с достоверным диагнозом ИВМ, наблюдавшихся за период с 1996 по 2016 г. Пациентам проводили лабораторное исследование, мануальное мышечное тестирование силы проксимальных мышц по 10-балльной шкале и электромиографическое исследование игольчатыми электродами.

Результаты и обсуждение. ПнМ был выявлен у 32 (10%) из 320 больных ИВМ. Среди пациентов с ПнМ было 6 (19%) мужчин и 26 (81%) женщин. Средний возраст дебюта ПнМ составлял 55,4 года. Дебют клинической картины болезни был представлен характерным кожно-мышечным синдромом у 19 (59%) пациентов, у 18 (41%) из них ЗН обнаружено в течение первого года от начала болезни. У 13 (41%) больных манифестация ЗН предшествовала картине ПМ/ДМ. Наиболее часто выявляли рак яичников (37,5%), ЗН легкого и молочной железы (15%), далее следовали ЗН кишечника (12,5%), крови (6,3%), матки (6%) и желудка (3,1%). Медиана выживаемости больных с ПнМ составила 5 лет.

1. Дворецкий ЛИ. Паранеопластические синдромы. Москва: MediaMedica; 2000 [Dvoretskii LI. Paraneoplasticheskie sindromy [Paraneoplastic syndromes]. Moscow: MediaMedica; 2000].

2. Shah AA, Casciola-Rosen L, Rosen A. Cancer-Induced Autoimmunity in the Rheumatic Diseases. Arthritis Rheum. 2015;67(2):317-26. doi: 10.1002/art.38928

3. Kameyama H, Shirai Y, Date K, et al. Gallbladder carcinoma presenting as exfoliative dermatitis (erythroderma). Int J Gastrointest Cancer. 2005;35:153-5. doi: 10.1385/IJGC:35:2:153

4. Chong VH, Lim CC. Erythroderma as the first manifestation of colon cancer. South Med J. 2009;102:334-5. doi:10.1097/SMJ.0b013e318191b8c0

5. Nomura T, Kodama K, Moriuchi R, et al. Papuloerythroderma of Ofuji associated with early gastric cancer. Int J Dermatol. 2008;47:590-1. doi: 10.1111/j.1365-4632.2008.03635.x

6. Nousari HC, Kimyai-Asadi A, Spegman DJ. Paraneoplastic dermatomyositis presenting as erythroderma. J Am Acad Dermatol. 1998;39:653-4. doi: 10.1016/S0190-9622(98)70022-2

7. Turchin I, Barankin B. Dermacase. Erythroderma secondary to cutanous T-cell lymphoma. Can Fam Physician. 2005;51:963, 971-3.

8. Grant-Kels JM, Bernstein ML, Rothe MJ. Exfoliative dermatitis. In: Wolff K, Goldsmith LA, Katz SI, et al, editors. Fitzpatrick's dermatology in general medicine. 7th ed. New York: McGrawHill; 2008. P. 225-32.

9. Dourmishev LA, Draganov PV. Paraneoplastic dermatological manifestation of gastrointestinal malignancies. World J Gastroenterol. 2009 Sep 21;15(35):4372-9. doi: 10.3748/wjg.15.4372

10. Levine SM. Cancer and myositis: new insights into an old association. Curr Opin Rheumatol. 2006;18:620-4. doi: 10.1097/01.bor.0000245721.02512.77

11. Dalakas MC, Hohlfeld R. Polymyositis and dermatomyositis. Lancet. 2003;362(9388):971-82. doi: 10.1016/S0140-6736(03)14368-1

12. Антелава ОА, Бондаренко ИБ, Чичасова НВ, Насонов ЕЛ. Респираторные нарушения при полмиозите/дерматомиозите. Современная ревматология. 2014;8(1):31-8 [Antelava OA, Bondarenko IB, Chichasova NV, Nasonov EL. Respiratory disorders in patients with polymyositis/dermatomyositis. Sovremennaya Revmatologiya = Modern Rheumatology Journal. 2014;8(1):31-8 (In Russ.)]. doi: 10.14412/1996-7012-2014-1-31-38

13. Dalakas M. Mechanisms of disease:signaling pathways and immunobyology of inflammatory myopathies. Nat Clin Pract Rheum. 2006;2(4):219-27. doi: 10.1038/ncprheum0140

14. Burns T, Breathnach S, Cox N, Griffiths C. The connective tissue diseases. In: Rook's Textbook of Dermatology. 8th ed. Chichester, West Sussex: John Wiley & Sons; 2004.

15. Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med. 1975;292:344-7. doi: 10.1056/NEJM197502132920706

16. Антелава ОА, Насонов ЕЛ. Современные методы оценки активности и повреждения при идиопатических воспалительных миопатиях. Научно-практическая ревматология. 2007;45(1):59-62 [Antelava OA, Nasonov EL. Modern methods of evaluation activity and damage in idiopathic inflammatory myopathies. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2007;45(1):59-62 (In Russ.)].

17. Yamasaki Y, Yamada H, Ohkubo M, et al. Longterm survival and associated risk factors in patients with adult-onset idiopathic inflammatory myopathies and amyopathic dermatomyositis: experience in a single institute in Japan. J Rheumatol. 2011 Aug;38(8):1636-43. doi: 10.3899/jrheum.101002. Epub 2011 May 15.

18. Santo AH, Souza JM, Pinheiro CE, et al. Trends in dermatomyositis- and polymyositis-related mortality in the state of Sao Paulo, Brazil, 1985–2007: multiple cause-of-death analysis. BMC Public Health. 2010 Oct 11;10:597. doi: 10.1186/1471-2458-10-597

19. Stertz G. Polymyositis. Berl Klin Wchnschr. 1916;53:489.

20. Kankeleit H. Uber primare nichteirige polymyositis. Dtsch Arch Klin Med. 1916;120:335-49.

21. Barnes BE, Mawr B. Dermatomyositis and malignancy. A review of the literature. Ann Intern Med. 1976;84:68-76. doi: 10.7326/0003-4819-84-1-68

22. Zahr ZA, Baer AN. Malignancy in myositis. Curr Rheumatol Rep. 2011;13:208-15. doi: 10.1007/s11926-011-0169-7

23. Hill CL, Zhang Y, Sigurgeirsson B, et al. Frequency of specific cancer types in dermatomyositis and polymyositis: a populationbased study. Lancet. 2001 Jan 13;357(9250):96-100. doi: 10.1016/S0140-6736(00)03540-6

24. Raffel GD, Gravallese EM, Schwab P, et al. Diagnostic dilemmas in oncology: case 2. Dermatomyositis and ovarian cancer. J Clin Oncol. 2001;19:4341-3.

25. Callen JP. Dermatomyositis and female malignancy. J Surg Oncol. 1986;32:121-4. doi: 10.1002/jso.2930320216

26. Chen YJ, Wu CY, Huang YL, et al. Cancer risks of dermatomyositis and polymyositis: a nationwide cohort study in Taiwan. Arthritis Res Ther. 2010;12(2):R70. doi: 10.1186/ar2987. Epub 2010 Apr 16.

27. So MW, Koo BS, Kim YG, et al. Idiopathic inflammatory myopathy associated with malignancy: a retrospective cohort of 151 Korean patients with dermatomyositis and polymyositis. J Rheumatol. 2011 Nov;38(11):2432-5. doi: 10.3899/jrheum.110320

28. Ang P, Sugeng MW, Chua SH. Classical and amyopathic dermatomyositis seen at the National Skin Centre of Singapore: a 3-year retrospective review of their clinical characteristics and association with malignancy. Ann Acad Med Singapore. 2000;29:219-23.

29. Olazagasti JM, Baez PJ, Wetter DA, ErnsteFC. Cancer risk in dermatomyositis: a meta-analysis of cohort studies. Am J Clin Dermatol. 2015 Apr;16(2):89-98. doi: 10.1007/s40257-015-0120-1

30. Callen JP. The value of malignancy evaluation in patients with dermatomyositis. J Am Acad Dermatol. 1982;6(2):253-9. doi: 10.1016/S0190-9622(82)70018-0

31. Buchbinder R, Forbes A, Hall S, et al. Incidence of malignant disease in biopsy-proven inflammatory myopathy. A populationbased cohort study. Ann Intern Med. 2001;134:1087-95. doi: 10.7326/0003-4819-134-12-200106190-00008

32. Chow WH, Gridley G, Mellemkjaer L, et al. Cancer risk following polymyositis and dermatomyositis: a nationwide cohort study in Denmark. Cancer Causes Control. 1995;6:9-13. doi: 10.1007/BF00051675

33. Sigurgeirsson B, Lindelof B, Edhag O, Allander E. Risk of cancer in patients with dermatomyositis or polymyositis. A populationbased study. N Engl J Med. 1992;326:363-7. doi: 10.1056/NEJM199202063260602

34. Stockton D, Doherty VR, Brewster DH. Risk of cancer in patients with dermatomyositis or polymyositis, and follow-up implications: a Scottish population-based cohort study. Br J Cancer. 2001;85:41-5. doi: 10.1054/bjoc.2001.1699

35. Airio A, Pukkala E, Isomaki H. Elevated cancer incidence in patients with dermatomyositis: a population based study. J Rheumatol. 1995;22:1300-3.

36. Насонов ЕЛ. Воспалительные заболевания мышц. Рациональная фармакотерапия ревматических заболеваний. Москва: Литтерра; 2003. С. 195-202 [Nasonov EL. Vospalitel’nye zabolevaniya myshts. Ratsional’naya farmakoterapiya revmaticheskikh zabolevanii [Rational pharmacotherapy of rheumatic diseases]. Moscow: Litterra; 2003. P. 195-202].

37. Marie I, Hatron PY, Levesque H, et al. Influence of age on characteristics of polymyositis and dermatomyositis in adults . Medicine (Baltimore). 1999;78:139-47. doi: 10.1097/00005792-199905000-00001

38. Ungprasert P, Leeaphorn N, Hosiriluck N, et al. Clinical features of inflammatory myopathies and their association with malignancy: a systematic review in asian population. ISRN Rheumatology. 2013;2013:Article ID 509354, 7 pages. doi: 10.1155/2013/509354. Epub 2013 Feb 25.

39. Chan HL. Dermatomyositis and cancer in Singapore. Int J Dermatol. 1985;24:447-50. doi: 10.1111/j.1365-4362.1985.tb05816.x

40. Leow YH, Goh CL. Malignancy in adult dermatomyositis. Int J Dermatol. 1997;36:904-7. doi: 10.1046/j.1365-4362.1997.00190.x

41. Peng JC, Sheen TS, Hsu MM. Nasopharyngeal carcinoma with dermatomyositis. Analysis of 12 cases. Arch Otolaryngol Head Neck Surg. 1995;121:1298-301. doi: 10.1001/archotol.1995.01890110072013

42. Chen YJ, Wu CY, Shen JL. Predicting factors of malignancy in dermatomyositis and polymyositis: a case-control study. Br J Dermatol. 2001;144:825-31. doi: 10.1046/j.1365-2133.2001.04140.x

43. Hatada T, Aoki I, Ikeda H, et al. Dermatomyositis and malignancy: case report and review of the Japanese literature. Tumori. 1996;82:273-5.

44. Tersiguel AC, Longueville C, Beltan E, et al. Prevalence of cancer in the Afro-Caribbean population presenting dermatomyositis and anti-synthetase syndrome: a preliminary study conducted at Pointe-a-Pitre University Hospital, 2000-2012. Ann Dermatol Venereol. 2014 Oct;141(10):575-80. doi: 10.1016/j.annder.2014.04.112. Epub 2014 May 17.

45. Lakhanpal S, Bunch TW, Ilstrup DM, Melton LJ III. Polymyositis-dermatomyositis and malignant lesions: does an association exist? Mayo ClinProc. 1986;61:645-53. doi: 10.1016/S0025-6196(12)62030-8

46. Manchul LA, Jin A, Pritchard KI, et al. The frequency of malignant neoplasms in patients with polymyositis-dermatomyositis. A controlled study. Arch Intern Med. 1985;145:1835-9. doi: 10.1001/archinte.1985.00360100097016

47. Masi AT, Hochberg MC. Temporal association of polymyositisdermatomyositis with malignancy: methodologic and clinical considerations. Mt Sinai J Med. 1988;55:471-8.

48. Danko K, Ponyi A, Molnar AP, et al. Paraneoplastic myopathy. Curr Opin Rheumatol. 2009;21(6):594-8. doi: 10.1097/bor.0b013e3283317fa5

49. Targoff IN. Idiopathic inflammatory myopathy: autoantibody update. Curr Rheumatol Rep. 2002;4(5):434-41. doi: 10.1007/s11926-002-0089-7

50. Casciola-Rosen L, Nagaraju K, Plotz P, et al. Enhanced autoantigen expression in regenerating muscle cells in idiopathic inflammatory myopathy. J Exper Med. 2005;201(4):591-601. doi: 10.1084/jem.20041367

51. Gallais V, Crickx B, Belaich S. Prognostic factors and predictive signs of malignancy in adult dermatomyositis. Ann Dermatol Venereol. 1996;123:722-6.

52. Basset-Seguin N, Roujeau JC, Gherardi R, et al. Prognostic factors and predictive signs of malignancy in adult dermatomyositis. A study of 32 cases. Arch Dermatol. 1990;126:633-7. doi: 10.1001/archderm.1990.01670290077012

53. Mahe E, Descamps V, Burnouf M, Crickx B. A helpful clinical sign predictive of cancer in adult dermatomyositis: cutaneous necrosis. Arch Dermatol. 2003;139:539.

54. Mautner GH, Grossman ME, Silvers DN, et al. Epidermal necrosis as a predictive sign of malignancy in adult dermatomyositis. Cutis. 1998;61:190-4.

55. Hunger RE, Durr C, Brand CU. Cutaneous leukocytoclastic vasculitis in dermatomyositis suggests malignancy. Dermatology. 2001;202:123-6. doi: 10.1159/000051611

56. Xu T, Hong S. A case of vesiculobullous dermatomyositis: a marker of internal malignancy. Int J Dermatol. 2012 May;51(5):594-6. doi: 10.1111/j.1365-4632.2011.05041.x

57. Ponyi A, Constantin T, Garami M, et al. Cancer-associated myositis: clinical features and prognostic signs. Ann N Y Acad Sci. 2005;1051:64-71. doi: 10.1196/annals.1361.047

58. Jurcic P. Dermatomyositis as the first manifestation of gallbladder adenocarcinoma: case report and literature overview. World J Surg Oncol. 2015 Mar 27;13(1):127. doi: 10.1186/s12957-015-0535-4

59. Kumar S, Mahajan BB, Kaur S, Singh A. Paraneoplastic dermatomyositis with carcinoma cervix: a rare clinical association. Case Rep Dermatol Med. 2014;2014:836246. doi: 10.1155/2014/836246. Epub 2014 Dec 18.

60. Wei Ge, Bu-Wei Teng, De-Cai Yu, et al. Dermatosis as the initial presentation of gastric cancer: two cases. Chin J Cancer Res. 2014 Oct;26(5):632-8. doi: 10.3978/j.issn.1000-9604.2014.10.01

61. Caratta PR, Mafort T, Pamplona M, et al. Paraneoplastic vesiculobullous dermatomyositis with synchronic prostate and tongue tumors: case report. Rev Bras Reumatol. 2011 Jul-Aug;51(4):394-6, 407.

62. Girouard SD, Velez NF, Penson RT, et al. Panniculitis associated with dermatomyositis and recurrent ovarian cancer. Arch Dermatol. 2012 Jun;148(6):740-4. doi: 10.1001/archdermatol.2012.288

63. Sontheimer RD. Dermatomyositis: an overview of recent progress with emphasis on dermatologic aspects. Dermatol Clin. 2002;20:387-408. doi: 10.1016/S0733-8635(02)00021-9

64. Sontheimer RD, Costner MI. Dermatomyositis. In: Wolff K, Goldsmith LA, Katz SI, et al, editors. Fitzpatrick's dermatology in general medicine. 7th ed. New York: McGraw-Hill; 2008. P. 1536-53.

65. Selvaag E, Thune P, Austad J. Dermatomyositis and cancer. A retrospective study. Tidsskr Nor Laegeforen. 1994;114:2378-80.

66. Andras C, Ponyi A, Constantin T, et al. Dermatomyositis and polymyositis associated with malignancy: a 21-year retrospective study. J Rheumatol. 2008;35:438-44.

67. Dai Y, Li P, Yan S, et al. Lung squamous carcinoma with two paraneoplastic syndromes: dermatomyositis and Lambert-Eaton myasthenic syndrome. Clin Respir J. 2014 Oct 22. doi: 10.1111/crj.12229

68. Sparsa A, Liozon E, Herrmann F, et al. Routine vs extensive malignancy search for adult dermatomyositis and polymyositis: a study of 40 patients. Arch Dermatol. 2002;138:885-90. doi: 10.1001/archderm.138.7.885

69. Fudman EJ, Schnitzer TJ. Dermatomyositis without creatine kinase elevation. A poor prognostic sign. Am J Med. 1986;80:329-32. doi: 10.1016/0002-9343(86)90036-7

70. Szankai Z, Nagy-Vincze M, Bodoki L, et al. Risk factors for cancer in patients with myositis. Clinical, immunological characteristics and the role of the anti-p155/140 antibody. Orv Hetil. 2014 Sep 7;155(36):1437-44. doi: 10.1556/OH.2014.29984

71. Ohashi M, Shu E, Tokuzumi M, et al. Anti-p155/140 antibodypositive dermatomyositis with metastasis originating from an unknown site. Acta Derm Venereol. 2011 Jan;91(1):84-5. doi: 10.2340/00015555-0955

72. Shimizu J. Malignancy-associated myositis. Brain Nerve. 2010 Apr;62(4):427-32.

73. Selva-O'Callaghan A, Trallero-Araguas E, Grau-Junyent JM, Labrador-Horrillo M. Malignancy and myositis: novel autoantibodies and new insights. Curr Opin Rheumatol. 2010 Nov;22(6):627-32. doi: 10.1097/BOR.0b013e32833f1075

74. Trallero-Araguas E, Labrador-Horrillo M, Selva-O'Callaghan A, et al. Cancer-associated myositis and anti-p155 autoantibody in a series of 85 patients with idiopathic inflammatory myopathy. Medicine (Baltimore). 2010 Jan;89(1):47-52. doi: 10.1097/MD.0b013e3181ca14ff

75. Ikeda N, Takahashi K, Yamaguchi Y, et al. Analysis of dermatomyositis-specific autoantibodies and clinical characteristics in Japanese patients. J Dermatol. 2011 Oct;38(10):973-9. doi: 10.1111/j.1346-8138.2011.01262.x

76. Targoff IN, Mamyrova G, Trieu EP, et al. A novel autoantibody to a 155-kd protein is associated with dermatomyositis. Arthritis Rheum. 2006;54(11):3682-9. doi: 10.1002/art.22164

77. Ichimura Y, Matsushita T, Hamaguchi Y, et al. Anti-NXP2 autoantibodies in adult patients with idiopathic inflammatory myopathies: possible association with malignancy. Ann Rheum Dis. 2012 May;71(5):710-3. doi: 10.1136/annrheumdis-2011-200697. Epub 2012 Jan 17.

78. Chinoy H, Fertig N, Oddis CV, et al. The diagnostic utility of myositis autoantibody testing for predicting the risk of cancerassociated myositis. Ann Rheum Dis. 2007;66:1345-9. doi: 10.1136/ard.2006.068502

79. Kaji K, Fujimoto M, Hasegawa M, et al. Identification of a novel autoantibody reactive with 155 and 140 kDa nuclear proteins in patients with dermatomyositis: an association with malignancy. Rheumatology (Oxford). 2007;46:25-8. doi: 10.1093/rheumatology/kel161

80. Fiorentino DF, Kuo K, Chung L, et al. Distinctive cutaneous and systemic features associated with antitranscriptional intermediary factor-1γ antibodies in adults with dermatomyositis. J Am Acad Dermatol. 2015 Mar;72(3):449-55. doi: 10.1016/j.jaad.2014.12.009. Epub 2015 Jan 14.

81. Plestilova L, Mann H, Andres Cerezo L, et al. The metastasis promoting protein S100A4 levels associate with disease activity rather than cancer development in patients with idiopathic inflammatory myopathies. Arthritis Res Ther. 2014;16(5):468. doi: 10.1186/s13075-014-0468-2

82. Cunningham MF, Docherty NG, Burke JP, O'Connell PR. S100A4 expression is increased in stricture fibroblasts from patients with fibrostenosing Crohn's disease and promotes intestinal fibroblast migration. Am J Physiol Gastrointest Liver Physiol. 2010;299:G457-66. doi: 10.1152/ajpgi.00351.2009

83. Klingelhö fer J, Senolt L, Baslund B, et al. Up-regulation of metastasis-promoting S100A4 (Mts-1) in rheumatoid arthritis: putative involvement in the pathogenesis of rheumatoid arthritis. Arthritis Rheum. 2007;56:779-89. doi: 10.1002/art.22398

84. Oslejskova L, Grigorian M, Hulejova H, et al. Metastasis-inducing S100A4 protein is associated with the disease activity of rheumatoid arthritis. Rheumatology (Oxford). 2009;48:1590-4. doi: 10.1093/rheumatology/kep316

85. Cerezo LA, Kuncova K, Mann H, et al. The metastasis promoting protein S100A4 is increased in idiopathic inflammatory myopathies. Rheumatology (Oxford). 2011;50:1766-72. doi: 10.1093/rheumatology/ker218

86. Hosono Y, Nakashima R, Imura Y, et al. Clinical and serological associations of malignancy in adult patients with polymyositis and dermatomyositis [abstract]. Arthritis Rheum. 2012;Suppl:abstr 216.

87. Marie I, Josse S, Decaux O, et al. Comparison of long-term outcome between anti-Jo1- and anti-PL7/PL12 positive patients with antisynthetase syndrome. Autoimmun Rev. 2012;11:739-45. doi: 10.1016/j.autrev.2012.01.006

88. Vesic S, Dakovic Z, Vukicevic J, et al. Dermatomyositis associated with metastatic rectal adenocarcinoma: case report. Med Pregl. 2009 Sep-Oct;62(9-10):473-5. doi: 10.2298/MPNS0910473V

89. Антелава ОА. Паранеопластический миозит. Особенности дебюта, клинической картины, течения, стероид-респонсивности. Научно-практическая ревматология. 2013;51(2):181-5 [Antelava OA. The specific features of the onset, clinical picture, steroid responsiveness of paraneoplastic myositis. NauchnoPrakticheskaya Revmatologiya = Rheumatology Science and Practice. 2013;51(2):181-5 (In Russ.)]. doi: 10.14412/1995-4484-2013-647

90. Chen D, Yuan S, Wu X, et al. Incidence and predictive factors for malignancies with dermatomyositis: a cohort from southern China. Clin Exp Rheumatol. 2014 Sep-Oct;32(5):615-21. Epub 2014 Jul 28.

91. Huang PY, Zhong ZL, Luo DH, et al. Paired study of 172 cases of nasopharyngeal carcinoma with or without dermatomyositis. Acta Otolaryngol. 2014 Aug;134(8):824-30. doi: 10.3109/00016489.2014.913312. Epub 2014 Jun 9.

92. Dias LP, Faria AL, Scandiuzzi MM, et al. A rare case of severe myositis as paraneoplastic syndrome on breast cancer. World J Surg Oncol. 2015 Apr 1;13(1):134. doi: 10.1186/s12957-015-0534-5

93. Rollo DD, Abeni D, Tracanna M, et al. Cancer risk in dermatomyositis: a systematic review of the literature. G Ital Dermatol Venereol. 2014 Oct;149(5):525-37. Epub 2014 Jun 30.

94. Bursac DS, Sazdanic-Velikic DS, Tepavac AP, Secen NM. Paraneoplastic dermatomyositis associated with adenocarcinoma of the lung. J Cancer Res Ther. 2014 Jul-Sep;10(3):730-2. doi: 10.4103/0973-1482.136028

95. Yang Z, Lin F, Qin B, et al. Polymyositis/dermatomyositis and malignancy risk: a metaanalysis study. J Rheumatol. 2015 Feb;42(2):282-91. doi: 10.3899/jrheum.140566. Epub 2014 Dec 1.

96. Scholz E, Trebing D, Knipping S. Dermatomyositis with tonsillar carcinoma. Rare presentation as paraneoplastic syndrome. HNO. 2014 Apr;62(4):282-5. doi: 10.1007/s00106-013-2682-7

97. Chakroun A, Guigay J, Lusinchi A, et al. Paraneoplastic dermatomyositis accompanying nasopharyngeal carcinoma: diagnosis, treatment and prognosis. Eur Ann Otorhinolaryngol Head Neck Dis. 2011 Jun;128(3):127-31. doi: 10.1016/j.anorl.2010.10.007

98. Ledwich LJ, Olenginski TP. A rare lymphoma in a patient with amyopathic dermatomyositis. Am J Clin Dermatol. 2010;11:151-5. doi: 10.2165/11530170-000000000-00000

99. Shen JK, Ding YM, Zhou WJ, Jin J. Polymyositis/dermatomyositis associated with acute myelocytic leukemia. Rheumatol Int. 2008;12:1265-7. doi: 10.1007/s00296-008-0600-1

100. Requena C, Alfaro A, Traves V, et al. Paraneoplastic dermatomyositis: a study of 12 cases. Actas Dermosifiliogr. 2014 Sep;105(7):675-82. doi: 10.1016/j.ad.2013.11.007. Epub 2014 Jan 30.

101. Cherin P, Piette JC, Herson S, et al. Dermatomyositis and ovarian cancer: a report of 7 cases and literature review. J Rheumatol. 1993;20:1897-9.

102. Davis MD, Ahmed I. Ovarian malignancy in patients with dermatomyositis and polymyositis: a retrospective analysis of fourteen cases. J Am Acad Dermatol. 1997;37:730-3. doi: 10.1016/S0190-9622(97)70109-9

103. Mordel N, Margalioth EJ, Harats N, et al. Concurrence of ovarian cancer and dermatomyositis. A report of two cases and literature review. J Reprod Med. 1988;33:649-55.

104. Fujita J, Tokuda M, Bandoh S, et al. Primary lung cancer associated with polymyositis/dermatomyositis, with a review of the literature. Rheumatol Int. 2001;20:81-4. doi: 10.1007/s002960000070

105. Xin Lu, Hanbo Yang, Xiaoming Shu, et al. Factors predicting malignancy in patients with polymyositis and dermatomyostis: A systematic review and meta-analysis. PLoS One. 2014;9(4):e94128. doi: 10.1371/journal.pone.0094128

106. Fain O, Hamidou M, Cacoub P, et al. Vasculitides associated with malignancies: analysis of sixty patients. Arthritis Rheum. 2007;57:1473-80. doi: 10.1002/art.23085

107. Fardet L, Dupuy A, Gain M, et al. Factors associated with underlying malignancy in a retrospective cohort of 121 patients with dermatomyositis. Medicine. 2009;88:91-7. doi: 10.1097/MD.0b013e31819da352

108. Wakata N, Kurihara T, Saito E, Kinoshita M. Polymyositis and dermatomyositis associated with malignancy: a 30-year retrospective study. Int J Dermatol. 2002 Nov;41(11):729-34. doi: 10.1046/j.1365-4362.2002.01648.x

109. Callen JP. When and how should the patient with dermatomyositis or amyopathic dermatomyositis be assessed for possible cancer? Arch Dermatol. 2002;138:969-71. doi: 10.1001/archderm.138.7.969

110. Suh KJ, Park JK, Cho S, et al. Dermatomyositis in a patient with cholangiocarcinoma detected by an [18F]-fluorodeoxyglucose positron emission tomography/computed tomography scan. Cancer Res Treat. 2016 Apr;48(2):848-52. doi: 10.4143/crt.2014.310

111. Fitzpatrick J, Wallace WA, Lang S, et al. Recurrent dermatomyositis manifesting as a sign of recurrent transitional cell carcinoma of urinary bladder: Long-term survival. Urol Ann. 2014 Jul;6(3):264-6. doi: 10.4103/0974-7796.134299