Dermatomyositis paraneoplastic syndrome before symptomatic tonsillar squamous cell carcinoma: a case report.
BACKGROUND
Paraneoplastic syndromes are systemic or organ-related functional tumor-associated changes that arise distant to the tumor.


RESULTS
We present a rare case of a 63-year-old man with dermatomyositis as a paraneoplastic syndrome developing more than a year before clinical manifestations of tonsillar squamous cell carcinoma (SCC). He subsequently developed stage T1N2bM0 IVA tonsillar SCC. He was treated on a research protocol with 3 weeks of neoadjuvant rapamycin therapy before right transoral lateral pharyngectomy and modified radical neck dissection with preservation of CN XI. His symptoms of dermatomyositis subsequently improved and he was weaned off immunosuppressive therapy.


CONCLUSIONS
To our knowledge, this is the first report of dermatomyositis as a paraneoplastic syndrome of tonsillar SCC in North America. We suggest that clinicians should monitor for signs of persistent or recurrent dermatomyositis symptoms as this may herald development or a return of the underlying malignancy.
Head and Neck Surgery Branch, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland.
Ahmad H
AH
Adi
Hani
H
Alturkmani
Todd
T
Spock
Patrice
P
Williams Yohannes
Susannah
S
Wargo
Eva
E
Szabo
J Silvio
JS
Gutkind
Carter
C
Van Waes
D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000473:pathology / Q000628:therapy; D003882:Dermatomyositis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000209:etiology*; D013997:Time Factors; D014067:Tonsillar Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy
carcinoma; dermatomyositis; paraneoplastic; squamous; tonsillar