PARANEOPLASTIC POLYMYOSITIS ASSOCIATED WITH A RENAL-CARCINOMA

A 56-year-old patient was admitted to hospital because of difficulties in swallowing and in opening his mouth. The serological transaminases were increased. Over the next 6 weeks a bioptically proven polymyosit is (more proximally located) caused a respiratory insufficiency which had to be treated by artificial respiration. A tetraplegia connected w ith a large increase of creatine-kinase was also seen. The general inv estigations were focused on malign processes with a particular search for bronchial carcinoma. At first a kidney cyst detected by ultrasound but was classified as harmless by several investigators. Finally, a c omputer tomogram of the abdomen demonstrated a cystic degenerated rena l carcinoma, which had been cytologically tested also. The clinical co urse showed a typical aspect of a paraneoplastic syndrome: after exten ded nephrectomy a distinct regression of the musculary symptoms develo ped, but with the development of metastases the symptoms increased aga in. The interdependence of polymyositis and primary renal carcinoma wo uld appear to be proven.