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DM Malignancy Screening — SCE Dermatology MCQ

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ModerateConnective Tissue & VasculitisDM Malignancy ScreeningSCE Dermatology

A 55-year-old man with dermatomyositis is being investigated for underlying malignancy. His anti-TIF1-gamma antibody is positive. CT chest/abdomen/pelvis is normal. What is the recommended duration of malignancy surveillance?

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Correct answer: AAt least 3-5 years from DM diagnosis with comprehensive screening repeated annually

For dermatomyositis patients at high risk of malignancy (particularly those with anti-TIF1-gamma antibodies, age >40, rapidly progressive disease), BAD and EULAR guidelines recommend malignancy screening at diagnosis and repeated annually for at least 3-5 years. The highest malignancy risk is within the first 3 years of DM diagnosis but can extend to 5 years. Screening should include: CT chest/abdomen/pelvis, age-appropriate cancer screening (mammography, cervical screening, colonoscopy, PSA), testicular examination in men, and ovarian cancer biomarkers (CA-125) in women. Some centres use PET-CT for comprehensive screening. A negative initial screen does not exclude future cancer development.

Reference: BAD 2016 DM Guidelines; EULAR 2017