A 77-year-old male with no relevant past medical history.
She consulted due to redness of the skin in the upper third of the chest and proximal part of both limbs, together with proximal muscle weakness in the arms folds, erythema in the eyelids and papules.
Laboratory tests were performed highlighting creatine kinase 736 IU, LDH 545 IU, urea 63 mg/dl, CA 19.9 64.1 U/ml.
Electromyogram: Findings compatible with inflammatory myopia.
Muscle biopsy: Inflammatory changes compatible with dermatomyositis.
With the diagnosis of dermatomyositis treatment was initiated with prednisone 60 mg/day and a CT scan revealed a pancreatic mass of 6 cm and hypodense liver lesions.
Hepatic biopsy: Adenocarcinoma.
Ongoing treatment is indicated.
After 8 weeks of corticoids, without improvement of skin lesions or muscle weakness, and in the presence of stage IVB pancreatic adenocarcinoma due to liver metastases, we started treatment with gemcitabine 1250 mg/m2 every 2 days.
Complete resolution of skin lesions, normalisation of muscle enzymes and recovery of strength are documented after 2 cycles of treatment.
Currently, the patient remains asymptomatic after 6 cycles of treatment and response is less than 50% of the underlying disease.
