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Anti-TIF1-gamma DM – Malignancy Screening — SCE Neurology MCQ

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HardPeripheral Neuropathy & NeuromuscularAnti-TIF1-gamma DM – Malignancy ScreeningSCE Neurology

A 58-year-old woman has new dermatomyositis with anti-TIF1-gamma antibodies, ulcerative skin disease and dysphagia. CT chest, abdomen and pelvis at diagnosis is normal. Under a risk-stratified cancer-screening approach, what is the most appropriate next plan?

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Correct answer: E — Arrange enhanced cancer screening at diagnosis and continue annual basic screening for three years, with selected further investigations guided by risk and findings

Anti-TIF1-gamma positivity, age over 40 and high-risk clinical features identify substantial cancer risk in dermatomyositis. IMACS recommends enhanced screening at diagnosis for high-risk disease and annual basic screening for three years; PET-CT or endoscopy may be considered selectively when initial investigations do not identify a cancer. A normal CT does not remove the time-associated malignancy risk, whereas indefinite universal PET-CT is not recommended.

Reference: IMACS cancer-screening guideline for idiopathic inflammatory myopathy: https://pubmed.ncbi.nlm.nih.gov/37945774/