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It occurs in 15%–30% of dermatomyositis cases and may indicate a poor, potentially fatal prognosis, particularly with advanced malignancies. The case describes a 58-year-old woman with low back pain and erythroderma, diffuse bone metastases, and breast adenocarcinoma confirmed by biopsy and immunohistochemistry, alongside cutaneous ADM features. Endocrine therapy plus corticosteroids and hydroxychloroquine produced partial improvement, but she later died from severe COVID-19 pneumonia complicated by pancytopenia and sepsis.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/paraneoplastic-amyopathic-dermatomyositis-associated-with-a-bone-and-medullary-location-of-breast-adenocarcinoma/366194/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/paraneoplastic-amyopathic-dermatomyositis-associated-with-a-bone-and-medullary-location-of-breast-adenocarcinoma/366194.png","ImageObject",300,407,{"name":92,"@type":93},"Đào","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is paraneoplastic amyopathic dermatomyositis (ADM) and how is it different from classic dermatomyositis?","Question",{"text":113,"@type":114},"Paraneoplastic ADM is characterized by dermatomyositis-like skin findings without clinical or laboratory evidence of muscle involvement. Classic dermatomyositis includes both skin and muscle symptoms, unlike ADM.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was the patient’s breast cancer confirmed in the case?",{"text":118,"@type":114},"Imaging showed diffuse bone metastases, and bone biopsy confirmed a poorly differentiated adenocarcinoma of breast origin. Immunohistochemistry demonstrated estrogen receptor positivity (60%), progesterone receptor positivity (35%), and GATA3 positivity, supporting the breast origin.",{"name":120,"@type":111,"acceptedAnswer":121},"What treatment was given for the malignancy and ADM, and what was the outcome?",{"text":122,"@type":114},"The patient started endocrine therapy with palbociclib and letrozole, along with corticosteroids and hydroxychloroquine, leading to partial clinical improvement. Within six months she developed severe COVID-19 pneumonia with pancytopenia and sepsis and ultimately died from multiorgan failure despite intensive care.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},366194,1790671200,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},1374402968488,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Review began 06/03/2025  \nReview ended 06/09/2025  \nPublished 06/15/2025  \n© Copyright 2025  \nHaboub et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.86031  \nOpen Access Case Report  \nParaneoplastic Amyopathic Dermatomyositis Associated With a Bone and Medullary Location of Breast Adenocarcinoma  \nFadwa Haboub 1, Mohamed El Fadli 2, Othmane Zouiten 1, Leila Afani 1, Rhizlane Belbaraka 1  \n1. Department of Medical Oncology, Centre Hospitalo-Universitaire Mohammed VI, Marrakesh, MAR 2. Department of Medical Oncology, Cadi Ayyad University, Marrakesh, MAR  \nCorresponding author: Fadwa Haboub, [dr.haboubfadwa@gmail.com](dr.haboubfadwa@gmail.com)  \nAbstract  \nParaneoplastic amyopathic dermatomyositis (ADM) is a rare connective tissue disease presenting with characteristic dermatomyositis-like skin findings in the absence of muscle involvement. It is associated with malignancies in 15%-30% of cases and may portend a fatal outcome, especially when linked to advanced cancers.  \nWe report the case of a 58-year-old woman who presented with progressive low back pain and erythroderma. Imaging revealed diffuse bone metastases, and bone biopsy confirmed a poorly differentiatedadenocarcinoma of breast origin (estrogen receptor, 60%; progesterone receptor, 35%; GATA3 positive) . Simultaneously, dermatological evaluation identified periungual erythema and other cutaneous findings consistent with ADM. The patient was started on endocrine therapy with palbociclib and letrozole, along with corticosteroids and hydroxychloroquine, resulting in partial clinical improvement.  \nHowever, within six months of diagnosis, she developed severe COVID-19 pneumonia, complicated by pancytopenia and sepsis, and ultimately succumbed to multiorgan failure despite intensive care support.  \nThis case underlines the importance of recognizing paraneoplastic ADM as an initial manifestation of malignancy. A multidisciplinary approach is key, but the prognosis largely depends on the cancer 's burden and complications such as treatment-induced immunosuppression.  \nCategories: Dermatology, Oncology, Therapeutics  \nKeywords: breast cancer, cdk4/6 inhibitors, erythroderma, medullary location, paraneoplastic amyopathicdermatomyositis  \nIntroduction  \nParaneoplastic amyopathic dermatomyositis (ADM) is a rare form of dermatomyositis, a connective tissue disease characterized by distinctive skin findings without clinical or laboratory evidence of muscle involvement [1] . Unlike classic dermatomyositis, which presents with both skin and muscle symptoms, ADM manifests with hallmark cutaneous signs such as Gottron’s papules and a heliotrope rash in the absence of muscle weakness or elevated muscle enzymes [1] .  \nA well-established association exists between dermatomyositis and malignancy. Studies have shown that approximately 15%-30% of patients with dermatomyositis have an underlying cancer, either at the time of diagnosis or shortly thereafter. Dermatomyositis can precede, coincide with, or follow the diagnosis of cancer, and virtually all types of malignancies have been reported, including breast, ovarian, lung, and gastrointestinal cancers [2] . In such cases, dermatomyositis is considered a paraneoplastic phenomenon, and the overall prognosis is closely tied to the type and stage of the associated tumor, as well as its response to therapy [2] .  \nIn this report, we present a rare case of paraneoplastic ADM associated with metastatic breast  \nadenocarcinoma involving the bone and spinal cord, highlighting the need for thorough malignancy  \nscreening in patients presenting with ADM.  \nCase Presentation  \nA 58-year-old woman with a history of high blood pressure was treated with monotherapy. Her history of the disease dates back one year to the onset ","cbCairp22BkqGcGV","https://ap.wps.com/l/cbCairp22BkqGcGV","pdf",3533473,"English","# Introduction\n# Case Presentation\n## Diagnostic workup and findings\n## Treatment course and outcome","[{\"question\":\"What is paraneoplastic amyopathic dermatomyositis (ADM) and how is it different from classic dermatomyositis?\",\"answer\":\"Paraneoplastic ADM is characterized by dermatomyositis-like skin findings without clinical or laboratory evidence of muscle involvement. Classic dermatomyositis includes both skin and muscle symptoms, unlike ADM.\"},{\"question\":\"How was the patient’s breast cancer confirmed in the case?\",\"answer\":\"Imaging showed diffuse bone metastases, and bone biopsy confirmed a poorly differentiated adenocarcinoma of breast origin. Immunohistochemistry demonstrated estrogen receptor positivity (60%), progesterone receptor positivity (35%), and GATA3 positivity, supporting the breast origin.\"},{\"question\":\"What treatment was given for the malignancy and ADM, and what was the outcome?\",\"answer\":\"The patient started endocrine therapy with palbociclib and letrozole, along with corticosteroids and hydroxychloroquine, leading to partial clinical improvement. Within six months she developed severe COVID-19 pneumonia with pancytopenia and sepsis and ultimately died from multiorgan failure despite intensive care.\"}]","Paraneoplastic Amyopathic Dermatomyositis Associated With a Bone and Medullary Location of Breast Adenocarcinoma | PDF",1790164175,18]