Parallel course of calcinosis and cancer in a patient with anti-NXP2-positive dermatomyositis: A case report.

BACKGROUND

In patients with dermatomyositis (DM) and anti-nuclear matrix protein 2 autoantibodies, associations with both cancer and calcinosis are well established. However, the relationship between the progression of calcinosis and the development of cancer remains unknown. Herein, we describe a unique case that prompts hypotheses regarding shared immunologic mechanisms underlying these clinical complications.

CASE PRESENTATION: We present the case of a 46-year-old woman diagnosed with biopsy-proven anti-nuclear matrix protein 2-positive DM manifesting as proximal muscle weakness, myalgias, pruritic rash, and elevations in creatine phosphokinase. Five years into her disease course, the patient developed an abrupt, coincident severe calcinosis and stage IIB squamous cell carcinoma of the cervix. She required aggressive immunosuppression, immunomodulation, and cancer therapy, which ultimately resulted in the remission of her cancer and improvement of her DM, with her calcinosis achieving a quiescent state. Her case describes a parallel course of calcinosis and cancer, and it highlights the challenges of managing refractory DM with malignancy.

CONCLUSIONS

Our case demonstrates that calcinosis and cancer can develop concurrently and follow a parallel course over time, suggesting a possible mechanistic link between the two complications. This report also highlights that communication between rheumatology, medical oncology, and radiation oncology is pivotal for optimally treating these complex patients.