Metastatic melanoma presenting with paraneoplastic dermatomyositis mimicking polymyalgia rheumatica.
Srikanth Akunuri, Stella Bowcock, Ashir Iqbal et al.
✦ AI-curated · Sources linked
Case in brief
A man in his late 70s presented with bilateral shoulder and hip girdle pain, morning stiffness, and significant weight loss over six weeks. Initially suspected of having polymyalgia rheumatica, further evaluation revealed markedly elevated creatine kinase levels and proximal weakness, leading to a diagnosis of paraneoplastic dermatomyositis. A CT scan showed extensive lymphadenopathy, and a biopsy confirmed metastatic melanoma. Treatment with corticosteroids and targeted therapy resulted in resolution of symptoms.
What made this case unusual
The case highlights paraneoplastic dermatomyositis mimicking polymyalgia rheumatica, an atypical presentation of metastatic melanoma.
Diagnostic / clinical pearl
Clinicians should consider paraneoplastic syndromes like dermatomyositis in patients with unexplained muscle weakness and significant weight loss, especially when initial diagnoses are inconclusive.
Why it matters
Recognizing the potential for paraneoplastic manifestations can lead to earlier diagnosis and treatment of underlying malignancies, improving patient outcomes.