title: Remission of paraneoplastic dermatomyositis associated with hepatocellular carcinoma under prednisolone and azathiopin, and concommittant sorafenib.
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.
  
  
  METHODS
  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.
authors.affiliation: Department of Medical Oncology, National Center for Tumor Diseases, Universität Heidelberg, Im Neuenheimer Feld 350, Heidelberg, Germany.
authors.forename: Leonidas
authors.initials: L
authors.lastname: Apostolidis
authors.forename: Christoph
authors.initials: C
authors.lastname: Kahlert
authors.forename: Annika
authors.initials: A
authors.lastname: Siegmund
authors.forename: Rabea
authors.initials: R
authors.lastname: Thom
authors.forename: Solveig
authors.initials: S
authors.lastname: Horstmann
authors.forename: Dirk
authors.initials: D
authors.lastname: Jäger
authors.forename: Florian
authors.initials: F
authors.lastname: Lordick
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001379:Azathioprine / Q000008:administration & dosage; D001557:Benzenesulfonates / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000188:drug therapy*; D003882:Dermatomyositis / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives; D010257:Paraneoplastic Syndromes / Q000175:diagnosis / Q000188:drug therapy*; D010671:Phenylurea Compounds; D011239:Prednisolone / Q000008:administration & dosage; D011725:Pyridines / Q000008:administration & dosage; D012074:Remission Induction; D000077157:Sorafenib; D016896:Treatment Outcome
chemical_list: D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D011239:Prednisolone; D000077157:Sorafenib; D001379:Azathioprine