title: Pancreatic adenocarcinoma-associated polymyositis treated with corticosteroids along with cancer specific treatment: case report.
abstract: BACKGROUND
  Adenocarcinoma of the pancreas only rarely is associated with inflammatory myopathy. In this setting, polymyositis may be treated with glucocorticoids in combination with cancer specific treatment.
  
  
  METHODS
  We present the case of a 52-year-old man with stage IIA pancreatic tail adenocarcinoma who underwent surgical treatment and six months into therapy with gemcitabine he developed symmetrical, painful, proximal muscle weakness with peripheral oedema. Re-evaluation with imaging modalities, muscle histology and biochemistry conferred the diagnosis of polymyositis associated with pancreatic cancer progression. The patient was treated with glucocorticoids along with gemcitabine and erlotinib which resulted in complete remission within six months. He remained in good health for a further six months on erlotinib maintenance therapy when a new computer tomography scan showed pancreatic cancer relapse and hence prompted 2nd line chemotherapy with gemcitabine.
  
  
  CONCLUSIONS
  Polymyositis associated with pancreatic cancer may respond to glucocorticoids along with cancer specific treatment.
authors.affiliation: Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Syrios
authors.forename: Georgios
authors.initials: G
authors.lastname: Kechagias
authors.forename: Ioannis D
authors.initials: ID
authors.lastname: Xynos
authors.forename: Maria N
authors.initials: MN
authors.lastname: Gamaletsou
authors.forename: Aristea
authors.initials: A
authors.lastname: Papageorgiou
authors.forename: George
authors.initials: G
authors.lastname: Agrogiannis
authors.forename: Nicolas
authors.initials: N
authors.lastname: Tsavaris
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000069347:Erlotinib Hydrochloride; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D017285:Polymyositis / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D011799:Quinazolines / Q000627:therapeutic use; D011877:Radionuclide Imaging; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D005938:Glucocorticoids; D011799:Quinazolines; D003841:Deoxycytidine; D000069347:Erlotinib Hydrochloride; D000093542:Gemcitabine