# Paraneoplastic Dermatomyositis Due to Gallbladder Carcinoma

## TL;DR

A 72-year-old woman with dermatomyositis was found to have gallbladder cancer, highlighting a rare paraneoplastic connection.

## Contribution

This case report highlights the rare association between gallbladder carcinoma and paraneoplastic dermatomyositis.

## Key findings

- The patient exhibited dermatomyositis symptoms alongside gallbladder carcinoma and liver metastasis.
- No improvement was observed with prednisolone treatment, and the patient passed away within a month.
- The case underscores the importance of considering cancer in dermatomyositis patients.

## Abstract

Dermatomyositis is an inflammatory myopathy that can be sporadic or paraneoplastic. A 72-year-old female presented with a subacute progressive illness characterized by symmetrical proximal weakness of upper and lower limbs, dysphagia, and neck flexor weakness. On examination, she had erythematous, scaly lesions over the periorbital areas, face, and interphalangeal and metacarpophalangeal joints (Gottron’s papules). Neurological examination revealed bilateral palatal palsy, proximal predominant upper and lower limb and neck flexor weakness, areflexia with preserved knee jerks, waddling gait, and normal sensory modalities. Investigations showed polymorphonuclear leukocytosis and elevated creatine kinase. Electromyogram revealed short-duration, small-amplitude polyphasic potentials with fibrillations and positive sharp waves consistent with inflammatory myopathy. Antinuclear antibodies and myositis antibodies were negative. Contrast-enhanced CT revealed a polypoidal lesion in the gallbladder with liver metastasis. She declined a biopsy and was started on prednisolone with minimal improvement. The patient expired one month later.