Dermatomyositis Related Paraneoplastic Encephalitis Presenting as Terminal Delirium in the Palliative Care Unit – A Case Report

Advanced cancers can have many complications including paraneoplastic processes such as dermatomyositis, hypercalcemia and encephalitis. Due to the wide-ranging nature of symptoms, the diagnosis requires a high index of suspicion and often requires a clinical diagnosis while awaiting for laboratory confirmation. Managing paraneoplastic phenomenon at the end of life requires robust goals of care conversations to determine what the patient is willing to go through to achieve specific goals. We present the case of a 50-year-old male with a history of squamous cell carcinoma presenting as unresolving delirium secondary to paraneoplastic encephalitis.