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CC BY 4.0 · Journal of Coloproctology 2024; 44(S 01): S1-S138
DOI: 10.1055/s-0045-1808651
Câncer do Cólon/Reto/Ânus
Colon/Rectal/Anus Cancer
ID – 138364
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COLORECTAL CANCER AND PARANEOPLASTIC DERMATOMYOSITIS: CASE REPORT

Authors

  • Gabriela Fonseca Lopes

    1   Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil

  • Lucas Faraco Sobrado

    1   Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil

  • Diego Fernandes Maia Soares

    1   Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil

  • Guilherme Cutait de Castro Cotti

    1   Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil

  • Caio Sergio Rizkallah Nahas

    1   Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil

  • Carlos Frederico Sparapan Marques

    1   Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil

  • Ulysses Ribeiro Junior

    1   Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil

  • Pedro Pastre Sponchiado

    1   Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
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Case Presentation A 40-year-old male, previously healthy, began oncological follow-up at a university hospital with a report of a 40 kg weight loss, abdominal cramps, and anemia. During the clinical investigation, a non-metastatic, stenosing adenocarcinoma was identified in the right colon, which was impassable via colonoscopy. In the perioperative period, the patient developed muscle pain and weakness in the scapular and pelvic girdles, a skin rash, and elevated creatine kinase (CPK). This combination of signs and symptoms led to the suspicion of dermatomyositis as a paraneoplastic syndrome, and a skin biopsy was performed on a lesion on the back of the hand. After evaluation by the rheumatology and neurology teams, preoperative immunoglobulin treatment was administered, leading to an improvement in the symptoms. The patient then underwent laparoscopic right colectomy with D2 lymphadenectomy, without anastomosis due to his clinical condition.

Discussion Malignancies most commonly associated with dermatomyositis include ovarian, lung, breast, pancreatic, gastric, colon, and prostate cancers, as well as non-Hodgkin lymphomas. Dermatomyositis (DM) is generally considered a paraneoplastic syndrome, occurring predominantly in women and in 96% of cases associated with adenocarcinomas. This syndrome typically regresses with the surgical treatment of the underlying neoplasm but may reappear with recurrence of the malignancy. The association between colorectal cancer and dermatomyositis is linked to a worse prognosis, with reported mortality in up to 85% of cases.

Conclusion In patients with dermatomyositis, it is essential to investigate underlying malignancies, as clinical symptoms may be related to a paraneoplastic syndrome. In this case report, the collaborative action of the multidisciplinary team was crucial to the patient’s treatment, from diagnosis to oncological surgery, enabling the management of this complex and rare condition.


No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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