Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2022; 10(27): 9727-9733
Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9727
Treatment of gastric cancer with dermatomyositis as the initial symptom: Two case reports and review of literature
Xiang-Fei Sun, Xiao-Dong Gao, Kun-Tang Shen
Xiang-Fei Sun, Xiao-Dong Gao, Kun-Tang Shen, Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai 200032, China
Author contributions: Sun XF collected the patient’s clinical data and drafted the manuscript; Gao XD helped in the management of the patient; Shen KT made revisions and supervision of the study; all authors read and approved the final manuscript.
Supported by the National Natural Science Foundation of China, No. 81773080.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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:
Corresponding author: Kun-Tang Shen, MD, Doctor, Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, No. 180 Fenglin Road, Shanghai 200032, China.
Received: May 18, 2022
Peer-review started: May 18, 2022
First decision: June 19, 2022
Revised: June 24, 2022
Accepted: August 14, 2022
Article in press: August 14, 2022
Published online: September 26, 2022

Dermatomyositis (DM) is a rare autoimmune disease involving the connective tissue. The association between DM and gastric cancer remains unclear. Patients with DM have an increased risk of cancer and higher mortality. It requires immunosuppressive therapy, heightened surveillance, and immunologic response to internal malignancy.


Two cases of gastric cancer with DM as the first symptom in Zhongshan Hospital, Fudan University (Shanghai, China) were reported. Two patients had a typical skin rash. The rash in the first patient involved mainly bilateral upper limbs and neck, while the second patient manifested rash associated mainly with the face, neck, and back. Both manifested muscle weakness in the extremities and elevated serum creatine kinase. Radical resection of the tumor dramatically improved DM-related symptoms in the two patients. The literature review showed that gastric cancer is more commonly associated with DM in middle-aged and older male populations.


The findings suggest the need for comprehensive screening for malignant tumors in patients with DM refractory to long-term pharmacotherapy or hormone manipulation.

Keywords: Gastric cancer, Dermatomyositis, Treatment, Literature review, Rash, Case report

Core Tip: Dermatomyositis is a rare autoimmune disease. Limited knowledge of the relationship between the disease and gastric cancer may complicate the diagnosis of gastric cancer. In this study, we report 2 cases of gastric cancer with dermatomyositis as the first symptom. A literature review was performed to further explore the relationship between dermatomyositis and gastric cancer.