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

Polymyositis is an inflammatory disease that causes bilateral proximal muscle weakness; unlike dermatomyositis, it is not usually associated with malignancy. However, there are a handful of case reports documenting polymyositis in patients with lymphoma, breast, lung, and bladder cancer. Here we report a case of metastatic pancreatic adenocarcinoma disguised by presenting as polymyositis. Clinical presentation, laboratory values, muscle biopsy, and imaging were all diagnostic of paraneoplastic polymyositis. The patient has significantly improved in symptoms are receiving systemic steroids and pancreaticoduodenectomy.

Peritoneal Carcinomatosis as an Initial Presentation of Gastrointestinal Stromal Tumor: A Case Report and Review of the Literature.

Gastrointestinal stromal tumors (GISTs) are a rare type of tumor with a high risk of malignant transformation. The majority of GISTs are asymptomatic. Surgical resection remains the mainstay of treatment given that GIST is resistant to traditional chemotherapy and radiotherapy. In the last two decades, the discovery of targeted therapy with tyrosine kinase inhibitor therapy (TKI) and widespread mutation analysis of tumors have transformed the treatment of GIST. We present a case of a patient in whom imaging findings were consistent with carcinomatous peritonitis concerning a gynecological malignancy but who was later found to have an unresectable GIST which locally regressed with TKI.

A nationwide cohort analysis to determine the prevalence of sinus node dysfunction and rates of pacemaker implantation in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) has been known to have various degrees of cardiac involvement. However, limited evidence exists on prevalence of heart rhythm disorders in patients with SLE who have subsequent pacemaker (PM) implantation. The purpose of this study was to examine the prevalence of sinus node dysfunction (SND) in patients with SLE. The data was retrospectively analysed from the National Inpatient Sample database for the years 2010 to 2014 using the International Classification of Disease-9 diagnosis codes for SLE and SND in patients 18 years or older. We analysed data of 158,368 patients with SLE that were admitted from 2010 to 2014. The sample of patients ranged between 18 and 101 years of age (M = 52.13 ± 17.61), were primarily female (88.2%), and were Caucasian (50.6%). The prevalence of SND was 4.3%. In patients with both SLE and SND, the prevalence of PM implantation over the five-year period of analysis was 3.6% and the majority of these patients had a dual-chamber PM (85.6%). Prevalence rates of SND in patients with SLE increased for females over this five-year period (p = 0.023). Prevalence estimates of complications associated with PM in patients with SLE and SND were venous thromboembolism (2.1%), cardiac tamponade (0.4%), sepsis and severe sepsis (0.4%), septic shock (0%), pneumothorax (0%) and PM site hematoma (1.7%). The findings of this study revealed that the prevalence of SND and the prevalence of PM in patients with both SLE and SND have remained relatively consistent over the five years that our study analysed.