03 July 2026
: Case report 
Pancreatic Adenocarcinoma Presented as Paraneoplastic Dermatomyositis Complicated with Rhabdomyolysis: Case Report and Review
Challenging differential diagnosis, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Jafar Alsheyyab ACDEF 1,2*, Hala Ahmad Al-Mahasneh BCEF 3, Shaimaa Y. Al-khalaileh ABCEF 1, Hamzah A. Hasan
BD 1,2, Khitam Al-Refu AEF 3
DOI: 10.12659/AJCR.952839
Am J Case Rep 2026; 27:e952839
Table 2 Summary of selected reported cases of paraneoplastic dermatomyositis associated with pancreatic cancer.
| Author (year) | Age/sex | Initial presentation | Muscle enzyme (CK) | Cancer type | Autoimmune markers | Treatment given | Outcome |
|---|---|---|---|---|---|---|---|
| Padniewski et al (2021) []18 | 61/M | Muscle weakness, leg swelling | 20 000 U/L | Pancreatic adenocarcinoma | ANA positive, anti-TIF1-γ negative | Corticosteroids | Improved but died 2 months later due to cancer |
| Costantini et al (2023) []7 | 78/F | Muscle weakness, jaundice | 36 000 U/L | Pancreatic adenocarcinoma | ANA negative | Steroids | Died 30 d after admission |
| Joshi et al (2008) []6 | 20/F | Acute onset quadriparesis, rhabdomyolysis | 29 000 U/L | NA | ANA and rheumatoid factor normal, negative | High doses of methylprednisolone | Improved |
| Decraene et al (2022) []19 | 69/M | Rhabdomyolysis, muscle weakness | 15 000 U/L | Pancreatic neuroendocrine carcinoma | ANCA negative, anti-TIF1-γ negative | Corticosteroids | Partial recovery |
| Eum et al (2006) []20 | 76/M | Pruritic skin rash, progressive weakness | 823 U/L | Pancreatic adenocarcinoma | Anti-double-strand DNA negative, anti-Smith antibody negative | Antihistamine, corticosteroids | Improved |
| Ahl et al (2025) []16 | 87/M | Rhabdomyolysis, renal failure | 15 000 U/L | Pancreatic adenocarcinoma | ANA positive | Corticosteroids | Partial recovery |
| Amroun et al (2012) []8 | 47/M | Polymyositis, limb weakness | NA | Pancreatic adenocarcinoma | NA | Tumor resection | Remission |
| Lee (2022) []17 | 82/F | Rhabdomyolysis, jaundice and weakness | 4400 U/L | Pancreatic ductal adenocarcinoma | ANA negative, anti-Smith antibody negative | Corticosteroids | Improved |
| Our case (2026) | 53/F | Rhabdomyolysis, acute kidney injury, rash | 25 229 U/L | Pancreatic adenocarcinoma | ANA positive, ENA negative | IV and oral steroids | Improved |
| Abbreviations: NA, not available; ANA, antinuclear antibody; ENA, extractable nuclear antigen. | |||||||