A liver tumour hid behind a muscle disease that standard tests missed
A man in his 70s with liver cancer developed dropped head syndrome. His muscle disease improved after surgery alone, with no immunosuppressive treatment.
A man in his 70s with hepatocellular carcinoma developed progressive proximal muscle weakness and dropped head syndrome. His creatine kinase was elevated, and muscle imaging and biopsy showed myopathic changes with necrotic and regenerating fibres, but no perifascicular necrosis.
Conventional serology was negative. Only a wheat germ cell-free protein synthesis-based assay (A-cube) detected anti-OJ antibodies, confirming a rare form of anti-synthetase syndrome. After a hepatic lobectomy, his weakness and laboratory abnormalities improved, without postoperative immunotherapy.
The authors say this is only the second reported case of anti-OJ-positive anti-synthetase syndrome linked to hepatocellular carcinoma, and both patients improved after tumour resection without immunosuppression. This is a case report, so it cannot establish causation. It suggests, but does not prove, a paraneoplastic mechanism, and it shows that standard assays can miss anti-OJ antibodies.
Summary prepared with AI assistance from the published abstract and reviewed by a physician. Not medical advice. Learn more
