title: Recurrent dermatomyositis manifesting as a sign of recurrent transitional cell carcinoma of urinary bladder: Long-term survival.
abstract: The association between urological malignancies and paraneoplastic syndromes has been well documented. We report a case of recurrent dermatomyositis manifesting as a sign of metastatic recurrence of non-muscle-invasive transitional cell carcinoma of the bladder, a relationship which has only been referred to in a few reports. The case highlights a few important clinical challenges; firstly, the importance of thorough investigation for underlying malignancy in patients with dermatomyositis, as successful treatment of such malignancy can lead to resolution of paraneoplastic symptoms, and secondly, a high index of suspicion of recurrence in cases where paraneoplastic manifestations recur. Metastatic pulmonary recurrence without local evidence of disease at a follow-up of 4 years makes this case unique. Moreover, in the light of our experience and reported literature, a framework is suggested to approach such a diagnostic dilemma in the future. Description of the case will guide clinicians in the future, in case they encounter such an unusual clinical scenario. This could also serve as a hypothesis-generating source for designing future research as well.
authors.affiliation: Department of Urology, Ninewells Hospital (NHS Tayside), Medical School, Medical Research Institute, University of Dundee, Dundee, Scotland (UK), DD1 9SY.
authors.forename: John
authors.initials: J
authors.lastname: Fitzpatrick
authors.affiliation: Department of Pathology, Royal Infirmary of Edinburgh (NHS Lothian), 51 Little France Crescent, Edinburgh EH16 4SA, Scotland.
authors.forename: William A
authors.initials: WA
authors.lastname: Wallace
authors.affiliation: Department of Pathology, Ninewells Hospital (NHS Tayside), Medical School, Medical Research Institute, University of Dundee, Dundee, Scotland (UK), DD1 9SY.
authors.forename: Stephen
authors.initials: S
authors.lastname: Lang
authors.affiliation: Department of Urology, Ninewells Hospital (NHS Tayside), Medical School, Medical Research Institute, University of Dundee, Dundee, Scotland (UK), DD1 9SY.
authors.forename: Omar M
authors.initials: OM
authors.lastname: Aboumarzouk
authors.affiliation: Department of Radiation Oncology, Ninewells Hospital (NHS Tayside), Medical School, Medical Research Institute, University of Dundee, Dundee, Scotland (UK), DD1 9SY.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Windsor
authors.affiliation: Department of Urology, Ninewells Hospital (NHS Tayside), Medical School, Medical Research Institute, University of Dundee, Dundee, Scotland (UK), DD1 9SY.
authors.forename: Ghulam
authors.initials: G
authors.lastname: Nabi
keywords: Bladder cancer; bladder neoplasm; dermatomyositis; paraneoplastic; transitional cell carcinoma