Paraneoplastic polymyositis associated with a renal carcinoma.
A 56-year-old patient was admitted to hospital because of difficulties in swallowing and in opening his mouth. The serological transaminases were increased. Over the next 6 weeks a bioptically proven polymyositis (more proximally located) caused a respiratory insufficiency which had to be treated by artificial respiration. A tetraplegia connected with a large increase of creatine-kinase was also seen. The general investigations were focused on malign processes with a particular search for bronchial carcinoma. At first a kidney cyst detected by ultrasound but was classified as harmless by several investigators. Finally, a computer tomogram of the abdomen demonstrated a cystic degenerated renal carcinoma, which had been cytologically tested also. The clinical course showed a typical aspect of a paraneoplastic syndrome: after extended nephrectomy a distinct regression of the musculary symptoms developed, but with the development of metastases the symptoms increased again. The interdependence of polymyositis and primary renal carcinoma would appear to be proven.
Wurzer
H
H
Second Medical Department, Graz General Hospital, Austria.
Brandstätter
G
G
Harnoncourt
K
K
Kullnig
P
P
Kleinert
R
R
D002292:Carcinoma, Renal Cell / Q000150:complications*; D002295:Carcinoma, Transitional Cell / Q000150:complications*; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000209:etiology*; D017285:Polymyositis / Q000209:etiology*