SUN-604 Dermatomiositis in a Patient with Papillary Thyroid Cancer: Simple Association or Paraneoplastic Syndrome?

The presentation of Dermatomyositis as a paraneoplastic syndrome is known. It is associated with malignancy of lung, pancreas, ovary, gastrointestinal and lymphoma not hodking. In thyroid neoplasias, the evidence is almost nil, with 8 cases published to date. Remission of Dermatomyositis does not always occur after thyroidectomy.A 24-year-old woman with hypothyroidism in treatment. In 6 months progressive hyperpigmentation is added in front, malar, nasogeniana, axillary, lumbar and popliteal region; asthenia and proximal muscle weakness that intensifies until hospitalization. On examination: 3N goiter, right thyroid nodule palpable, TSH: 4.9, T4L: 1.1, total CPK: 6579, LDH: 2791, popliteal and lumbosacral hyperpigmentation biopsy: Acanthosis Nigricans. Electromyography: Inflammatory Myopathy, Muscle Biopsy: Dermatomyositis. ANA: speckled pattern 1: 320, other exams: normal. With these findings and fulfilling the criteria of Bohan and Peter is diagnosed Dermatomyositis. We proceed to the search for hidden neoplasms discarding those commonly associated. Thyroid ultrasound: hypoechoic image in left lobe, vascularized, ill-defined edges of 11x10 mm. BAAF: Bethesda VI. Thyroglobulin: 6.84 ng / m, Anti-thyroglobulin: 67.68 IU / mL. Total thyroidectomy was performed with group VI dissection. AP: Classic type Papillary Carcinoma pT3N1a. Dermatomyositis was managed with pulses of methylprednisolone leaving the hospital with oral corticotherapy, there was moderate improvement in muscle weakness, with persistence of hyperpigmentation.Although there is controversy between the association of these two entities, we consider it important to include thyroid cancer in the search for hidden neoplasms. The corresponding permission was requested to the patient to use his information for academic purposes.