Fallopian tube cancer associated with paraneoplastic dermatomyositis -- asymptomatic multivisceral exacerbated dermatomyositis mimicking recurrent widespread malignant disease: case report.
OBJECTIVE
To report an uncommon case of a recurrent episode of primarily paraneoplastic dermatomyositis which was completely disconnected from the initially triggering malignancy and manifested as a silent pure multivisceral exacerbation.


METHODS
A 70-year-old woman presented with a pure multivisceral episode of dermatomyositis without characteristic musculo-cutaneous symptoms one year after successful treatment of fallopian tube carcinoma with complete resolvement of a concomittant paraneoplastic dermatomyositis. The uncommon manifestation of recurrent dermatomyositis involving the lungs, spleen and liver, both adrenal glands and abdominal lymph nodes, mimicked a highly disseminated recurrence of the fallopian tube cancer. Physicians participating in the interdisciplinary tumor board were misled to opt for reinductive chemotherapy. Only histologic diagnosis obtained from multiple biopsies uncovered the inflammatory nature of the disease and spared the patient unneeded chemotherapy.


CONCLUSIONS
Asymptomatic multivisceral dermatomyositis may mimic metastatic spread of the initially underlying malignancy and may misdirect therapeutic strategies towards inadequate antineoplastic treatment.
Seeber
J
J
Department of Obstetrics and Gynecology, Innsbruck Medical University, Austria.
Reimer
D
D
Müller-Holzner
E
E
Spizzo
G
G
Sepp
N
N
Wiesbauer
P
P
Marth
C
C
Zeimet
A G
AG
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D002277:Carcinoma / Q000150:complications*; D018549:Cryptogenic Organizing Pneumonia / Q000000981:diagnostic imaging / Q000209:etiology; D003882:Dermatomyositis / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D005185:Fallopian Tube Neoplasms / Q000150:complications*; D005260:Female; D006801:Humans; D010257:Paraneoplastic Syndromes / Q000188:drug therapy / Q000503:physiopathology*; D012008:Recurrence; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones