Dermatomyositis-Like Multicentric Reticulohistiocytosis: A Clinical Clue to Verify Underlying Malignancy

Abstract

Herein, an otherwise healthy 63-year-old Caucasian woman with a three month-history of progressive symmetrical swelling and of the fingers, lumbal and abdominal pain, proximal muscle weakness, and heliotropic rash resembling V- neck, histologically verified as multicentric reticulohistiocytosis (MRH), is presented. Multiple computer tomography scans failed to detect ovarian cancer despite elevated Ca 125, however, it was verified six months later by magnetic resonance investigation. Multicentric reticulohistocytosis (MRH) is a rare systematic disease that targets skin, mucoses and synovium, resulting in skin nodules, mucosal lesions and deforming painful mutilating polyarthritis. Twenty – five percent of all patients are associated with internal malignancies, hence, MRH paraneoplastic nature remains extremely controversial. Our case showed a peculiar dermatomyositis-like clinical subtype, which we consider suggestive for verification of an underlying malignancy.