To the Editor.
—Tubular aggregates in skeletal muscle have been described in an increasing variety of disorders, including periodic paralysis; muscular dystrophies; inflammatory myopathies; chronic alcoholism; familial neuromuscular disease characterized by myalgia; and a variety of drug exposures, including anticonvulsants.1-7 We report the observation of tubular aggregates in skeletal muscle from a patient with neoplastic disease and suggest that a pathogenetic relationship may exist between the development of tubular aggregates and the disturbance in calcium metabolism and regulation that frequently occurs in neoplastic disease.
Report of a Case.
—A 73-year-old man with no prior history of myalgias, muscle cramps, or muscle weakness presented with a 3-month history of orthostatic hypotension with occasional syncope, night sweats, and a 7-kg weight loss. His blood pressure was 120/60 mm Hg supine, with a pulse rate of 90 beats per minute. On standing, his blood pressure dropped to 70/42 mm Hg, with a