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824 Paraneoplastic dermatomyositis: case report
  1. Siwar Abdessaied,
  2. Bouchra Oumayma Naija,
  3. Delia Yazid,
  4. Sabrine Tbessi,
  5. Rihem Fayala,
  6. Souha Messaoudi,
  7. Samia Belajouza,
  8. Nadia Bouzid and
  9. Sameh Tebra
  1. Farhat Hached University Hospital, Sousse, Tunisia


Introduction/Background Dermatomyositis is an autoimmune myopathy associated with skin lesions. it rarely manifests as a symptom of the paraneoplastic syndrome.

Amyopathic dermatomyositis accounts for around 20% of all cases of dermatomyositis and is often associated with breast cancer.

We report an observation of amyopathic dermatomyositis revealing a breast cancer relapse.

Methodology This is a 65-year-old patient who is followed for infiltrating ductal carcinoma of the left breast grade SBR III, hormone receptor positive, Her2neu negative and Ki67 at 10% associated with local inflammatory signs and is therefore classified T4dN1M0. She was treated with neoadjuvant chemotherapy followed by left Patey and letrozole hormonal therapy. She was proposed for locoregional radiotherapy of the chest wall. Prior to radiotherapy, the patient was admitted to the dermatology department for a dermatosis which, on examination, showed erythema of the orbits, purplish erythema of the neckline, back and upper limbs, and 03 erythematous nodules measuring 01 cm located on the mastectomy scar. No muscular weakness associated.

The diagnosis was paraneoplastic amyopathic dermatomyositis.

The Biopsy of these nodules showed recurrence of a non-specific, triple-negative infiltrating ductal carcinoma on a mastectomy scar, with an updated negative extension report.

The patient underwent surgery for a local relapse. Pathological examination of the surgical specimen revealed recurrence of a modified SBR II non-specific multifocal infiltrating carcinoma on a mastectomy scar, hormone receptors positive for oestrogen and negative for progesterone, no overexpression of Her2neu and Ki67 at 22%.

She was put on 0.5 mg/kg corticosteroids for her dermatosis.

She will have locoregional radiotherapy at a dose of 40 Gy and a BOOST of 13.35 Gy.

Results Clinical outcomes showed no significant improvement and persistent pruritic dermatological lesions.

Conclusion Paraneoplastic syndromes are a factor in both the diagnosis and monitoring of certain tumours. When dermatomyositis occurs in patients with a history of breast cancer, a relapse must be sought as a priority

Disclosures No conflicts of interest are declared.

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