Abstract
A 55 year-old male patient with double primary carcinoma of the lung was admitted.Cytological examinations revealed synchronous double lung cancers, small cell carcinoma in the right upper lobe and adenocarcinoma in right S9.
Soon after right pneumonectomy, heliotrope-like erythema, proximal muscle pain and weakness appeared, and elevation of skeletal muscle enzyme levels was recognized.
Under a diagnosis of dermatomyositis, steroid therapy was started and the muscular symptoms were improved. However, the erythema was unchanged.
Six weeks after initiation of steroid therapy, he had a remittent pyrexia with sudden dyspnea. His chest X-ray showed a reticulo-nodular shadow. He deteriorated fulminantly and died 4 days after the onset of respiratory symptoms. Postmortem histological examination of the lung revealed fibrosing alveolitis.
Combination of three such diseases is thought to be rare compared to the combination Of the two diseases lung cancer and dermatomyositis. The intercorrelation among lung cancer, dermatomyositis and fibrosing alveolitis was discussed with a review of the literature.
