Paraneoplastic dermatomyositis preceding detection of metastatic oesophageal squamous cell carcinoma after prolonged remission following pembrolizumab therapy.
Syed Adil Hassan, Kasturi Hazarika, Prashant Kumar Rai
✦ AI-curated · Sources linked
Case in brief
A man in his late fifties with a history of treated oesophageal squamous cell carcinoma developed severe dermatomyositis after six years of remission. He presented with progressive muscle weakness, dysphagia, and elevated creatine kinase levels. Imaging revealed metastatic disease in the thoracic oesophagus, lymph nodes, and liver. Treatment with corticosteroids and chemotherapy led to significant improvement in both his symptoms and tumor burden.
What made this case unusual
This case highlights the development of dermatomyositis after a prolonged remission from oesophageal squamous cell carcinoma, which is an uncommon association.
Diagnostic / clinical pearl
Clinicians should consider paraneoplastic syndromes like dermatomyositis in patients with a history of malignancy who present with new inflammatory myopathy.
Why it matters
Recognizing the potential for paraneoplastic manifestations after long-term remission can aid in early detection of recurrent malignancy.