皮膚筋炎様症状を契機に診断された尿管癌の1例

Abstract

We here report a case of dermatomyositis associated with ureteral cancer. A 69-year-old male presented to our hospital complaining of a rash on his whole body, which resulted in a clinical diagnosis of dermatomyositis. Right ureteral cancer was suspected on computed tomographic CT examination during the investigation for the underlying malignancy. The patient was treated with prednisolone and right nephroureterectomy with bladder cuffing for dermatomyositis and ureteral cancer, respectively. One year after surgery, the dermatomyositis worsened, and CT examination showed local recurrence and lymph node metastasis. Chemotherapy was performed, and CT examination 3 months after treatment showed that the tumor had shrunk. Skin symptoms were also ameliorated. Chemotherapy was given intermittently thereafter. The tumor then increased and skin symptoms reappeared ; 3 years after surgery the patient's general condition deteriorated, resulting in death. Ureteral cancer with dermatomyositis is rare, but dermatomyositis complicated with malignancy has a poor prognosis. Careful whole body search may be useful for early detection of malignancy.