Anti-TIF1γ Antibody-Positive Dermatomyositis: A Case Report and Literature Review Emphasizing on Malignancy Screening Interval
Keywords:
dermatomyositis, malignancy, anti-transcription intermediary factor 1 gamma, nasopharyngeal carcinomaAbstract
Anti-transcription intermediary factor 1 gamma (TIF1-γ) antibody-positive dermatomyositis (DM) is highly associated with malignancy; thus, cancer screening is essential. Malignancies associated with DM frequently manifest around the time of development of the skin rash, and the risk of malignancy were believed to be high up to three years after the diagnosis of DM. Herein, we report a 54-year-old Thai man who presented with erythematous plaques on the head, neck, and extremities, accompanied with dysphagia for 6 months, and was subsequently diagnosed with amyopathic DM based on positive antinuclear antibody, normal muscle enzymes, and clinicopathologic findings. Routine malignancy screening was performed at the disease onset and revealed negative results. However, after approximately five years, he presented with otologic symptoms. Computed tomography scan of nasopharynx showed an infiltrative lesion at left-sided nasopharynx, and the nasopharyngeal mucosa biopsy revealed non-keratinizing nasopharyngeal carcinoma. Since anti-TIF1γ antibodies are linked to an increased risk of cancer, it is crucial for physicians to develop cancer screening plans tailored to the specific population. Extending cancer screening beyond the recommended three-year period using a risk-stratified, cost-effective, and age-appropriate approach may beneficial for the detection of cancer in DM patients while minimizing unnecessary and invasive investigations.
References
Karino K, Fujieda Y, Kawamura T, et al. Anti-TIF1γ antibody predicted malignancy of thymic tumor with dermatomyositis as an "autoimmune tumor marker": A case report. Medicine (Baltimore) 2018;97:e13563.
Palterer B, Vitiello G, Cammelli D. First report of anti-TIF1γ dermatomyositis in a patient with myelodysplastic syndrome. Reumatismo 2017;69:75-7.
Ogawa-Momohara M, Muro Y, Mitsuma T, et al. Strong correlation between cancer progression and anti-transcription intermediary factor 1γ antibodies in dermatomyositis patients. Clin Exp Rheumatol 2018;36:990-5.
Motegi SI, Sekiguchi A, Ikeuchi H, et al. Clinical features of anti-transcription intermediary factor 1γ (TIF1γ)-positive dermatomyositis with internal malignancy and investigation of the involvement of TIF1γ expression in tumors in the pathogenesis of cancer-associated dermatomyositis. J Dermatol 2020;47:1395-402.
Lau L, Huang L, Fu E, Tan TC, Kong KO, Lim MY. Nasopharyngeal carcinoma in dermatomyositis. Clin Otolaryngol 2021;46:1082–8.
Russo R, Gasparini G, Cozzani E, Gravina B, Parodi A. Paraneoplastic Wong-Type Dermatomyositis Associated with Gynecological Malignancy. Medicina (Kaunas). 2022;58:484.
Ee HL, Ng PP, Tan SH. Exacerbation of amyopathic dermatomyositis in Orientals: a high alert for nasopharyngeal carcinoma. Australas J Dermatol 2004;45:77-8.
Chanprapaph K, Limtong P, Ngamjanyaporn P, Suchonwanit P. Trichoscopic Signs in Dermatomyositis, Systemic Lupus Erythematosus, and Systemic Sclerosis: A Comparative Study of 150 Patients. Dermatology 2022;238:677-87.
Chanprapaph K, Fakprapai W, Limtong P, Suchonwanit P. Nailfold Capillaroscopy With USB Digital Microscopy in Connective Tissue Diseases: A Comparative Study of 245 Patients and Healthy Controls. Front Med (Lausanne) 2021;8:683900.
Chen YJ, Wu CY, Shen JL. Predicting factors of malignancy in dermatomyositis and polymyositis: a case-control study. Br J Dermatol 2001;144:825-31.
Harada Y, Tominaga M, Iitoh E, et al. Clinical Characteristics of Anti-TIF-1γ Antibody-Positive Dermatomyositis Associated with Malignancy. J Clin Med 2022;11:1925.
Nakanishi Y, Yamaguchi K, Yoshida Y, et al. Coexisting TIF1γ-positive Primary Pulmonary Lymphoepithelioma-like Carcinoma and Anti-TIF1γ Antibody-positive Dermatomyositis. Intern Med 2020;59:2553-8.
Teo P, Tai TH, Choy D. Nasopharyngeal carcinoma with dermatomyositis. Int J Radiat Oncol Biol Phys 1989;16:471-4.
Oldroyd AGS, Callen JP, Chinoy H, et al. International Guideline for Idiopathic Inflammatory Myopathy-Associated Cancer Screening: an International Myositis Assessment and Clinical Studies Group (IMACS) initiative. Nat Rev Rheumatol 2023;19:805-17.
Iorizzo LJ, 3rd, Jorizzo JL. The treatment and prognosis of dermatomyositis: an updated review. J Am Acad Dermatol 2008;59:99-112.
Ito K, Imafuku S, Hamaguchi Y, Fujimoto M, Nakayama J. Case report of anti-transcription intermediary factor-1-γ/α antibody-positive dermatomyositis associated with gastric cancer and immunoglobulin G4-positive pulmonary inflammatory pseudotumor. J Dermatol 2013;40:567-9.
Kabuto M, Fujimoto N, Teramura K, et al. A case of dermatomyositis with esophageal fistula in whom blind mucosal biopsy detected occult oropharyngeal carcinoma. Case Rep Dermatol 2014;6:268-73.
Kubeček O, Soukup T, Paulík A, Kopecký J. Dermatomyositis with anti-TIF-1γ antibodies as a presenting symptom of underlying triple-negative breast cancer: a case report. BMC Cancer 2016;16:684.
Ogawa M, Sugiura K, Yokota K, Muro Y, Akiyama M. Anti-transcription intermediary factor 1-γ antibody-positive clinically amyopathic dermatomyositis complicated by interstitial lung disease and breast cancer. J Eur Acad Dermatol Venereol 2016;30:373-5.
Aritomi T, Kido T, Nakano K, et al. Small Cell Lung Cancer Patient with Anti-transcriptional Intermediary Factor 1γ Antibody Who Developed Dermatomyositis after Successful Chemoradiotherapy. Intern Med 2019;58:427-31.
Teraishi M, Nakajima K, Ishimoto T, Yamamoto M, Maeda N, Muro Y, et al. Anti-transcription intermediary factor 1γ antibody titer correlates with clinical symptoms in a patient with recurrent dermatomyositis associated with ovarian cancer. Int J Rheum Dis 2018;21:900-2.
Merry E, Smrke A, Halai K, et al. Paraneoplastic dermatomyositis associated with metastatic leiomyosarcoma of unknown primary. Clin Sarcoma Res 2020;10:15.
Sumazaki M, Kaneko K, Ito M, et al. A Case of Dermatomyositis Along with Esophageal Cancer and Screening of Serum Transcriptional Intermediary Factor 1 Gamma Antibodies in Various Cancer Patients. Am J Case Rep 2020;21:e922004.
Arnon J, Elia A, Nevo Y, Lossos A, Nechushtan H. SCLC, Paraneoplastic Dermatomyositis, Positive Transcription Intermediary Factor 1-γ, and Point Mutation in the Transcription Intermediary Factor 1-γ Coding Gene: A Case Report. JTO Clin Res Rep 2021;2:100217.
Asano R, Shinoda K, Tsuda R, et al. Anti-TIF1γ antibody-positive dermatomyositis in a 15-year-old boy with Epstein-Barr virus-related nasopharyngeal cancer receiving nivolumab. Rheumatology (Oxford) 2021;60:e197-e9.
Liu HL, Chen YH. Ovoid palatal patch: a portentous sign in dermatomyositis. Qjm. 2023;116:377-8.
Poelman A, Neerinckx B, Beuselinck B, De Langhe E. Systemic autoimmune rheumatic diseases as paraneoplastic phenomena: 3 illustrative case reports and narrative review of the literature. Acta Clin Belg 2023;78:410-7.
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