325 Dermatomyositis as a paraneoplastic syndrome in high grade serous ovarian carcinoma: a case report and review of literature

Dermatomyositis occurring as a paraneoplastic syndrome in a high grade serous ovarian carcinoma is rare and treating the disease condition is a challenge. A 46-year-old, nulligravid presented with an eight-month history of rash, joint pain, and progressive muscular weakness. Dermatomyositis was diagnosed in the background of cutaneous manifestations, progressive muscle weakness, elevated muscle enzymes and electromyographic findings. She was treated with prednisone, however during the course of treatment, she had an emergency exploratory laparotomy for a pelvic mass in complication. The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, right hemicolectomy, and ileocolic side to side anastomosis. Histopathology revealed a high grade serous ovarian carcinoma, with a presumptive stage IIB. Post-operatively, the myositis partially improved. Steroid therapy was continued for two months. Chemotherapy was delayed because of repeated infections due to her immunosuppressed state. Dermatomyositis is highly associated with malignancy. Early detection as well as treatment of the underlying malignancy can improve survival of this simultaneous condition.