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1998 Presentations for the Poster and Vignette Sessions
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DERMATOMYOSITIS AND ITS ASSOCIATION WITH MALIGNANCY: A CLASSIC PRESENTATION. Timothy C. Meyer, D.O., Gundersen Lutheran Medical Foundation, La Crosse, Wisconsin.

This is a case of a 78­year­old female patient who presents with proximal myalgia, muscle weakness, and a several month history of intermittent rectal bleeding with left lower quadrant abdominal discomfort. On exam a classical heliotropic rash and Gottron plaques were noted. Laboratory data revealed elevation of her creatine kinase.

Dermatomyositis and its association with malignancy is well described in the literature. In this patient a barium enema revealed an abnormal narrowing and loss of colonic mucosal pattern. Subsequent colonoscopy was performed. A colonic mass at 65 cm. was discovered. Biopsy of the mass was significant for poorly differentiated adenocarcinoma.

When a patient presents with Dermatomyositis an evaluation for a primary malignancy must be considered. If a malignancy is discovered, the treatment of choice is to remove the tumor if possible. Upon treatment of the primary malignancy the symptoms of Dermatomyositis should resolve. The use of Glucocorticoids is warranted until the primary malignancy can be treated. The prognosis of patients with Dermatomyositis depends on the discovery of a primary malignancy, the patient's age, and other comorbid conditions.

This case and the pictures presented show Dermatomyositis in its classic form. Truly, a picture is worth a thousand words.

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