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Not a Statin-Induced Myopathy: Metastatic Pancreatic Adenocarcinoma Presenting As Paraneoplastic Myositis

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Polymyositis is an inflammatory myopathy that usually presents with bilateral proximal muscle weakness and inflammatory necrotizing infiltrates within striated muscle on histopathology [1]. There are three proposed classifications for polymyositis: primary idiopathic, childhood, and malignancy-associated [2]. Polymyositis is more often associated with Raynaud’s phenomenon, interstitial lung disease, lupus, rheumatoid arthritis, scleroderma, and other connective tissue diseases [2]. However, inflammatory myopathies and their association with malignancy have been reported in the literature.

The close temporal relationship between polymyositis onset and diagnosis of malignancy and improvement of symptoms with paraneoplastic syndrome treatment suggests a further association [3]. More specifically, polymyositis has been reported to occur as paraneoplastic syndromes in patients with lymphoma, breast, lung, and bladder cancers [4]. Paraneoplastic polymyositis is rarely associated with pancreatic adenocarcinoma, with less than a handful of documented cases. We present an unusual case of metastatic pancreatic cancer disguised within the paraneoplastic syndrome of polymyositis. Read more . .  .

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