DISSCUSSION
The correlation between inflammatory myopathies and the occurrence of
cancer has been recognized for almost a century, yet its interpretation
and importance have remained ambiguous(11). Hill and colleagues have
published a comprehensive dataset that provides substantial evidence
regarding the association between myositis and malignancy(12). A total
of 618 individuals with dermatomyositis and 914 individuals with
polymyositis were successfully identified in the study. The incidence of
cancer was observed in approximately 30% of patients with DM and 15%
of patients with PM, with a notable majority of tumors being identified
subsequent to the initial diagnosis of myopathy.
The correlation between myopathies, which manifest as a component of a
paraneoplastic syndrome, and the presence of cancer is widely
acknowledged within the scientific community(13). Nevertheless, the
progress of epidemiological investigations in this area has been impeded
by limited sample sizes, the influence of referral bias, and
inconsistencies in diagnostic methodologies.
The spectrum of tumors linked to DM or PM mirrors the distribution
observed in the broader population, with the potential deviations being
a heightened occurrence of cervical(14), lung(15), ovarian(16),
pancreatic(17), bladder(18), and gastric carcinomas(19), as well as
non-Hodgkin lymphoma(20). The occurrence of cancer can be ascertained
prior to, during, or subsequent to the diagnosis of myositis, with a
notable surge in frequency observed within the two-year timeframe
encompassing the onset and progression of myositis. Furthermore, it is
worth noting that in certain individuals, the manifestation of myositis
is initially identified during a relapse of a previously diagnosed
neoplasm, whereas in other cases, myositis resurfaces coinciding with
the onset of evident malignancy. Our patient was diagnosed with
inflammatory myopathy based on clinical presentations. This specific
instance exemplifies the significance of possessing comprehensive
understanding regarding correlated paraneoplastic syndromes, as such
knowledge can prove instrumental in resolving infrequent yet critical
diagnostic dilemmas. The timely identification of malignancy is of
utmost importance in instances involving polymyositis. The acquisition
of any subtle indications that can assist clinicians in their diagnostic
endeavors is of utmost significance. Consequently, our investigation
underscores the criticality of contemplating neoplasms as a potential
differential diagnosis for patients who exhibit symptoms of myopathy.
Despite its infrequency, myopathy can manifest as the initial symptom
during presentation, thereby furnishing clinicians with a pivotal clue
that may facilitate an earlier identification of concealed malignancies.