Abstract
A 69-year-old woman presented to the Emergency Room with a several-week history of intermittent right upper limb swelling, proximal muscle weakness, and debilitating pain. Physical exam revealed findings consistent with dermatomyositis and asymmetrical right upper limb swelling. Initial investigations did not establish a cause for the swelling; however, a deltoid muscle biopsy showed inflammatory infiltrate with a myositis, and surrounding edema. This was likely related to a spiculated lung opacity discovered on chest radiograph. Unfortunately, the patient deteriorated, developing diffuse alveolar damage and succumbed to this injury. Subsequent autopsy determined that the source for this rare presentation of both edematous dermatomyositis and diffuse alveolar damage was primary lung adenocarcinoma. This is the first described case presentation of two rare clinical manifestations associated with a lung malignancy: edematous dermatomyositis and diffuse alveolar damage.
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