Dermatomyositis Associated With Papillary Thyroid Cancer Systematic Review of the Literature and a Case Report

Objective: There is a well-known association between malignancy and dermatomyositis but reports of an association between malignancies of the thyroid gland and dermatomyositis are very few. Here we describe a recent case of dermatomyositis found to have thyroid cancer during screening and review the clinical features of the similar cases in literature. Methods: The case history, treatment responses and follow up data are described. We performed a systematic literature review using the keywords (thyroid cancer OR thyroid carcinoma) AND dermatomyositis. Results: 35 year old male presented with an acute onset of symptoms including facial rash, widespread myalgia, muscle weakness and dysphagia. Patient was diagnosed with dermatomyositis based on clinical findings, laboratory, electromyography and imaging results and immunosuppressive treatment initiated. Screening for cancer revealed a papillary thyroid carcinoma. Thyroidectomy was performed and immunosuppressive medication was gradually tapered and stopped. At 24 months following the diagnosis patient remains in remission. This is the 14th reported case of dermatomyositis and thyroid cancer in the English literature. Analysis of data from these 14 cases while revealing conflicting insights about the link between dermatomyositis and thyroid cancer do not rule out this possibility. Treatment of thyroid cancer appeared to have a significant influence on the course of dermatomyositis in at least six of these cases. Conclusion: Better recognition of the link between dermatomyositis and thyroid cancer may allow physicians to protect some dermatomyositis patients from morbidity and mortality associated with immunosuppression.