Remission of paraneoplastic dermatomyositis associated with hepatocellular carcinoma under prednisolone and azathiopin, and concommittant sorafenib

Onkologie. 2009 Feb;32(1-2):50-3. doi: 10.1159/000183750. Epub 2009 Jan 19.

Abstract

Background: Hepatocellular carcinoma (HCC) is one of the most common tumor diseases worldwide. Dermatomyositis is a known paraneoplastic syndrome that can complicate the course of a variety of different cancers, however, the association with HCC is extremely rare.

Case report: Here, we report on a patient with the rare concurrence of dermatomyositis and non-hepatitis-associated advanced HCC with intra-abdominal and intrathoracal lymph node metastases. The HCC was treated with sorafenib. The dermatomyositis responded well to treatment with prednisolone and azathioprin although sorafenib did not lead to a response in the underlying HCC.

Conclusions: Paraneoplastic dermatomyositis can be associated with non-hepatitis-associated HCC. The potential pathogenetic links between these two diseases are discussed, as well as a potential immunomodulatory effect of sorafenib independent of its antineoplastic potential.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Azathioprine / administration & dosage
  • Benzenesulfonates / administration & dosage
  • Carcinoma, Hepatocellular / diagnosis
  • Carcinoma, Hepatocellular / drug therapy*
  • Dermatomyositis / diagnosis
  • Dermatomyositis / drug therapy*
  • Humans
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / therapy
  • Male
  • Middle Aged
  • Niacinamide / analogs & derivatives
  • Paraneoplastic Syndromes / diagnosis
  • Paraneoplastic Syndromes / drug therapy*
  • Phenylurea Compounds
  • Prednisolone / administration & dosage
  • Pyridines / administration & dosage
  • Remission Induction
  • Sorafenib
  • Treatment Outcome

Substances

  • Benzenesulfonates
  • Phenylurea Compounds
  • Pyridines
  • Niacinamide
  • Prednisolone
  • Sorafenib
  • Azathioprine