Fatal exacerbation of paraneoplastic systemic sclerosis after neoadjuvant chemotherapy in a breast cancer patient.
Paraneoplastic systemic sclerosis (SSc) occurs in about 3%-7% of individuals with SSc. There are reports of accelerated SSc syndromes associated in particular with breast cancer. Further exacerbations of the rheumatic condition may be induced by treatment of the cancer. We report a 30-year-old African-American woman with a contiguous diagnosis of breast cancer and paraneoplastic SSc. She was treated with neoadjuvant chemotherapy and developed an accelerated SSc syndrome with pericarditis and cardiac tamponade, with lethal results. This case report stresses the need for control of the rheumatic condition prior to the initiation of antineoplastic therapy.
Kochhar
Ruby
R
Winship Cancer Institute, Emory University School of Medicine, PO Box 55440, Atlanta, GA 30308, USA. Ruby_Kochhar@emory.org
Umbreit
Jay N
JN
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy*; D002305:Cardiac Tamponade / Q000139:chemically induced; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003520:Cyclophosphamide / Q000009:adverse effects*; D004317:Doxorubicin / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D010257:Paraneoplastic Syndromes / Q000139:chemically induced*; D010493:Pericarditis / Q000139:chemically induced; D012595:Scleroderma, Systemic / Q000139:chemically induced* / Q000150:complications
D000970:Antineoplastic Agents; D004317:Doxorubicin; D003520:Cyclophosphamide