gms | German Medical Science

Introduction: Dermatomyositis is a rare idiopathic inflammatory of muscle with skin involvement. The peak incidence is found in childhood and at the 50th age, with women being affected more frequently. In up to 50% of cases, the disease is associated with tumors as paraneoplastic syndrome. In adults preferred cancers of the gastrointestinal tract, breast and female genitals, lungs, and T-cell lymphoma are described. As the cause of dermatomyositis an autoimmune etiology or a viral infection is discussed.

Methodology: It demonstrates the case of a 56 year old patient who was treated with a unclear cervical lymph node swelling first introduced in our clinic. It was a year before a diagnosis of dermatomyositis. Because of a cervical lymphadenopathy a PET-CT was carried out.

Results: A lymph node resection was done. The histology revealed the metastasis of a lymphoepithelial carcinoma. As part of the evaluation of a CUP syndrome, a panendoscopy, nasopharyngeal-PE and tonsillectomy were performed. As the primary tumor a carcinoma of the right tonsil was found. In addition, a hilar and mediastinal lymph node metastases and meningitis carcinomatosa was detected. It has launched an intrathecal chemotherapy and systemic chemotherapy.

Conclusion: Dermatomyositis is a tumor-associated disease. The temporal relationship between onset of dermatomyositis and the occurrence of a tumor is different. For this reason, an intensive tumor screening is very important and should be repeated at regular intervals with negative results. The tonsillar carcinoma is rare in this context.