Paul Aritra, Mukhopadhyay Abheepsita, Ghosh Sudip Kumar, Samanta Kaustav, Das Subhabrata
Department of Surgery, Nil Ratan Sircar Medical College and Hospital, Kolkata, IND.
Department of Surgery, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, IND.
Cureus. 2020 Sep 30;12(9):e10730. doi: 10.7759/cureus.10730.
Dermatomyositis (DM), as a paraneoplastic presentation, is rare, though the incidence of malignancies in patients with DM is very high. While it has been reported with a wide range of cancers, association with gallbladder carcinoma is uncommon. Furthermore, signet ring cell carcinoma detected in the metastasis presumably from our patient's gallbladder mass is itself a rare and highly malignant variant of gallbladder adenocarcinoma. Thus, this association can be considered to be a very novel finding. We describe the case of a 64-year-old Indian man who presented with cervical lymph node swelling concurrent with facial rashes, periorbital oedema, nasal regurgitation, dysphagia and weakness in his limbs. The presence of characteristic Gottron's papules and shawl-like truncal rash on examination led to the diagnosis of DM. Fine needle aspiration cytology (FNAC) of the cervical lymph nodes revealed metastatic signet ring cells, and contrast-enhanced CT (CECT) scan of the abdomen showed a significant gallbladder mass with liver infiltration, thus confirming the underlying association.
皮肌炎（DM）作为一种副肿瘤表现较为罕见，不过DM患者中恶性肿瘤的发生率很高。虽然DM与多种癌症有关，但与胆囊癌的关联并不常见。此外，在转移灶中检测到的印戒细胞癌推测来自我们患者的胆囊肿块，其本身是胆囊腺癌中一种罕见且高度恶性的变体。因此，这种关联可被视为一项非常新颖的发现。我们描述了一名64岁印度男性的病例，他出现颈部淋巴结肿大，同时伴有面部皮疹、眶周水肿、鼻反流、吞咽困难和四肢无力。检查时发现特征性的Gottron丘疹和披肩样躯干皮疹，从而诊断为DM。颈部淋巴结细针穿刺细胞学检查（FNAC）显示有转移性印戒细胞，腹部增强CT（CECT）扫描显示胆囊有明显肿块并伴有肝脏浸润，从而证实了潜在的关联。
