The 478 th case: multiple myalgia with intramuscular nodules
10.3760/cma.j.cn112138-20190705-00475
- VernacularTitle:第478例——多发肌肉疼痛伴肌内结节
- Author:
Jiao PENG
1
;
Kunpeng LI
;
Jingyu JIN
;
Jinshui YANG
;
Jianglin ZHANG
Author Information
1. 解放军总医院第一医学中心（原解放军总医院）风湿病科，北京 100853；南开大学医学院，天津 300071
- From:
Chinese Journal of Internal Medicine
2020;59(6):485-488
- CountryChina
- Language:Chinese
-
Abstract:
A 28-year-old man was admitted to the first medical center of Chinese People′s Liberation Army General Hospital because of multiple myalgia and intramuscular nodules for more than 2 months. The patient complained of dysphagia, fever and weight loss 2 months ago. Magnetic resonance imaging and biopsy revealed nodular fasciitis. Inflammatory indicators including C-reactive protein, erythrocyte sedimentation rate, platelet count and fibrinogen were slightly elevated. Urine occult blood was positive. Abdominal ultrasound revealed left hydronephrosis. Because nodular fasciitis could not explain the whole situation, a needle biopsy of intramuscular nodules was performed. Pathological examination revealed intramuscular metastatic adenocarcinoma with poor differentiation. Gastric endoscope and positron emission tomography-computed tomography confirmed the diagnosis of advanced gastric adenocarcinoma with extensive metastases of esophagus, lymph nodes, muscles, ureter and bone. Although chemotherapy was given, the patient died of disease progression six months later.
