Dermatomyositis and Gynaecological Cancer: Case Report and Literature Review

Two cases of paraneoplastic dermatomyositis associated to an ovarian and endometrial cancer are reported and a literature review is performed. Case report and literature review. Hospital 12 de Octubre. Madrid. Spain. Two patients with dermatomyositis with rapid onset and progress of the disease and lack of response to standard treatment. Review of clinical data, diagnostic tools, treatment and evolution. Literature review. We present two patients with diagnosis of dermatomyositis without serological abnormalities and with disease progression despite conventional therapy. One of them was diagnosed of ovarian carcinoma stage IIIc during the initial evaluation and in the other one an endometrium adenocarcinoma stage Ib was found in the second evaluation performed one year after. In both patients a markedly clinical improvement of their dermatitis was noted once the associated neoplasms were properly treated. The association between cancer and dermatomyositis has been firmly established, and affects about 25% of patients above the age of 50, with a described standarized incidence ratio for malignancy of up to 7.7. Malignant disease may occur before, concurrently or afterward the onset of myositis. The most commonly locations are breast and genital tract among women, lung among men and gastrointestinal system in both sexes. The essential aim of the disease management must be the recognition of the associated neoplasm and its treatment. The evaluation should be different depending on the patient's age and sex, and should be repeated if the clinical course of the disease changes or once during three to five years, as the risk of neoplastic association is still high.