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World J Clin Oncol. Dec 10, 2015; 6(6): 295-298
Published online Dec 10, 2015. doi: 10.5306/wjco.v6.i6.295
Carcinoma of unknown primary and paraneoplastic dermatomyositis
Amir Sonnenblick
Amir Sonnenblick, Sharett Institute of Oncology, Medical Center of Hadassah-Hebrew University, Ein Kerem, Jerusalem 91120, Israel
Author contributions: Sonnenblick A designed and performed research; analyzed the data and wrote the paper.
Conflict-of-interest statement: The author has no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Amir Sonnenblick, Sharett Institute of Oncology, Medical Center of Hadassah-Hebrew University, P.O. Box 12000, Ein Kerem, Jerusalem 91120, Israel. amirsonn@gmail.com
Telephone: +972-2-6757729
Received: April 17, 2015
Peer-review started: April 21, 2015
First decision: June 3, 2015
Revised: September 14, 2015
Accepted: October 12, 2015
Article in press: October 13, 2015
Published online: December 10, 2015
Processing time: 235 Days and 22.9 Hours
Abstract

Dermatomyositis is known to be associated with neoplastic disorders, however the presentation of carcinoma of unknown primary as dermatomyositis is rare. We describe a case index of 50-year-old female who presented with enlarged inguinal lymph nodes accompanied with symmetric proximal muscle weakness and erythematous plaques. Conventional basic work-up did not reveal the diagnosis, however, positron emission tomography-computed tomography and re-staining of the pathology specimen suggested the ovaries as the primary site. Chemotherapy including carboplatin paclitaxel and bevacizumab led to complete response of disease and improvement in the dermatomyositis. The present case emphasizes the importance of a thorough directed evaluation for the underlying cancer in patients with carcinoma of unknown primary presenting as dermatomyositis. We further provide an up-to-date detailed review of published data describing these clinical entities.

Keywords: Paraneoplastic, Dermatomyositis, Cancers of unknown primary, Positron emission tomography

Core tip: The presentation of carcinoma of unknown primary as dermatomyositis is rare. Positron emission tomography-computed tomography and pathology case oriented evaluation may identify the site of origin. We provide an up-to-date detailed review of published data describing these clinical entities.