Paraneoplastic myopathy-related rhabdomyolysis and pancreatic cancer:A case report and review of the literature  

作　　者：Andrea Costantini Lucia Moletta Elisa Sefora Pierobon Simone Serafini Michele Valmasoni Cosimo Sperti 

机构地区：[1]Department of Surgical,Oncological and Gastroenterological Sciences,UOC Chirurgia Generale 1,University of Padua,Padua 35128,Italy [2]Department of Surgical,Oncological and Gastroenterological Sciences,UOC Chirurgia Generale 2,University of Padua,Padua 35128,Italy

出　　处：《World Journal of Clinical Cases》2023年第28期6823-6830,共8页世界临床病例杂志

摘　　要：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(>120000μg/L,n.v.12-70μg/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.

关 键 词：Paraneoplastic myopathy RHABDOMYOLYSIS Pancreatic cancer Acute renal failure Paraneoplastic myositis Prognosis Case report 

分 类 号：R735.9[医药卫生—肿瘤]