Dermatomyositis as a paraneoplastic phenomenon in oesophageal cancer

Abstract

Dermatomyositis is a multisystem disease manifesting as an idiopathic inflammatory myopathy, characterised predominantly by cutaneous and muscular abnormalities. Patients with dermatomyositis display characteristic skin changes in addition to muscle weakness. Many consider dermatomyositis a paraneoplastic syndrome, as up to 32% of patients with dermatomyositis will develop cancer. Discussed here is the case of a 69-year-old man with a new diagnosis of dermatomyositis who was referred to a tertiary institution with an 8-month history of rash, proximal muscle weakness, fatigue and weight loss. In the absence of clinical symptoms, negative cancer markers and a negative CT chest, abdomen and pelvis, positron emission tomography–CT prompted a gastroscopy, which led to the discovery of a stage T1b oesophageal adenocarcinoma. The oesophageal adenocarcinoma was treated with a gastrointestinal endoscopic mucosal resection and subsequent oesophajectomy. The patient’s dermatomyositis was treated successfully with oral prednisolone and methotrexate.

Vesiculobullous Paraneoplastic Dermatomyositis: A Case Report and Review of the Literature

“…Adult-onset dermatomyositis (DM) is an idiopathic inflammatory myopathy frequently associated with underlying cancer including breast, ovary, lung and cervix carcinoma. Many consider dermatomyositis a paraneoplastic syndrome, as up to 32% of patients with the disease will develop cancer (1) . The characteristic skin findings are heliotrope sign, Gottron's papules and poikyloderma.…”