A Case Report of gastric cancer with amyopathic dermatomyositis

Abstract

A 62-year-old man perceived skin itch and general fatigue from September 2009. He had pointed out liver dysfunction in blood examination and introduced to our hospital. In our hospital, blood examination revealed the elevation of the CK level. He has been recognized erythema from frontal to parietal area of head and symmetric edematous erythema in nasal and buccal area. In addition, he was shown reddish purple edematous erythema of the upper eyelid and desquamative erythema on the dorsal hands. We performed skin biopsy and diagnosed dermatomyositis. Because his symptom of the dermatomyositis was slight, we did not give the steroid therapy. No abnormalities was pointed out in other physical views. Other organs must be examined because this dermal disease is often related to the complication of malignant tumors. He was diagnosed gastric cancer at anterior wall of cardia part of stomach by gastrointestinal fiber. Since the abnormal findings were not pointed out in chest CT and colonoscopy, we decided to treat gastric tumor prior to the skin disorder. We performed total gastrectomy and reconstructed by Roux-en Y method. The skin symptom of the patient was improved after surgery. It was reported that skin symptom was relieved by resection of tumor. Some cases of dermatomyositis emerge without muscular manifestations, and these cases are termed amyopathic dermatomyositis. We reported case of gastric cancer with amyopathic dermatomyositis suggesting improvement of skin symptom by resection of tumor.