Dual Diagnosis: Unraveling Ankylosing Spondylitis in a Cancer Patient

Abstract

There have been several recent studies that indicate that patients with rheumatological diseases are at a higher risk of developing malignant neoplasms than the general population. This clinical case presents a patient with ankylosing spondylitis, a rare autoimmune disease in women, in addition to breast cancer. The close relationship between rheumatology and malignancy highlights the challenges in terms of diagnosis, treatment, and prevention, making this case highly relevant. Furthermore, this case also highlights the positive effect of chemotherapy drugs used in the treatment of breast cancer on the autoimmune disease. Therefore, further research in this area is necessary to gain a better understanding of the complex interplay between rheumatology and malignancy.

Keywords: ankylosing spondylitis; autoimmune disease; breast cancer; chemotherapy; psoriasis.

Figure 1. MRI of sacroiliac joints

MRI conclusion: The joint space is seen throughout. Moderate bilateral joint space widening. The articular surfaces on both sides are clear and uneven with the presence of subchondral sclerosis. Some very subtle defects in the lower third of the joints are seen on both sides. Trabecular edema is present on the subchondral sections on both sides, on the right lower third of the joint, and on the left throughout. MRI: magnetic resonance imaging

Figure 2. (A) HER2 immunohistochemistry at 10× magnification, (B) ER immunohistochemistry at 10× magnification, (C) PR immunohistochemistry at 10× magnification, (D) Ki67 immunohistochemistry at 10× magnification, and (E) AR immunohistochemistry at 10× magnification

All immunohistochemical stainings were done using hematoxylin and eosin. HER2: human epidermal growth factor receptor 2, ER: estrogen receptor, PR: progesterone receptor, AR: androgen receptor

Figure 3. Timeline of the patient's manifestations and interventions