title: Dermatomyositis and chest radiography leading to the diagnosis of lung cancer and subsequent confusions in staging due to the presence of tuberculosis.
abstract: This clinical scenario describes dermatomyositis as a presenting feature of carcinoma of the lung. However, the coincident existence of tuberculosis in the opposite lung gave rise to a false impression of contralateral lung metastasis and hence confusions with regard to staging ensued, which were clarified after further investigation confirmed a unilateral lung adenocarcinoma and contralateral tuberculosis. The patient was initiated on oral antiepidermal growth factor receptor therapy with erlotinib, as well as on multi-drug therapy for tuberculosis. This report intends to illustrate that paraneoplastic syndromes such as dermatomyositis can be the presenting feature of lung cancer, and also that the co-incident presence of carcinoma and tuberculosis can cause confusions with regard to staging and management.
authors.affiliation: Radiation Therapy and Oncology Department, Regional Cancer Center, Indira Gandhi Medical College, Shimla, India. swarooptheone@gmail.com
authors.forename: Swaroop
authors.initials: S
authors.lastname: Revannasiddaiah
authors.forename: Manoj Kumar
authors.initials: MK
authors.lastname: Gupta
authors.forename: Madhup
authors.initials: M
authors.lastname: Rastogi
authors.forename: Avinash Arjun Rao
authors.initials: AA
authors.lastname: Kesari
authors.forename: Rajeev Kumar
authors.initials: RK
authors.lastname: Seam
authors.forename: Manish
authors.initials: M
authors.lastname: Gupta
authors.forename: Suneel
authors.initials: S
authors.lastname: Chauhan
authors.forename: Irappa
authors.initials: I
authors.lastname: Madabhavi
mesh_terms: D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D003882:Dermatomyositis / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D000069347:Erlotinib Hydrochloride; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008297:Male; D009367:Neoplasm Staging; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011799:Quinazolines / Q000627:therapeutic use; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging* / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride