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Context Dermatomyositis is a rare autoimmune disease characterized by noninfectious inflammatory damage of skin and predominant muscles in the belts. It is believed to be associated with about 1 in 1000 cases of nasopharyngeal carcinoma. This association has been described for locally advanced stages II and III nasopharyngeal carcinoma. It has rarely been described in the early stages (stage I). Case presentation A 65-year-old Moroccan patient residing in Casablanca, with no particular history was referred to the Mohamed VI Center for the treatment of cancers of the University Hospital Center IBN ROCHD in Casablanca, for treatment of nasopharyngeal cancer. He was admitted in poor general condition, performance status 3, with erythema on the face, neck, and extremities. The diagnosis of paraneoplastic dermatomyositis was made owing to progressive muscle weakness and elevation of muscle enzymes associated with the typical rash of the face and hands. He received corticosteroid therapy and then radiotherapy to the nasopharynx with good clinical outcome, disappearance of skin lesions, and recovery of muscle strength. Conclusions We report this case of dermatomyositis in early-stage nasopharyngeal carcinoma, which is a rarely described entity. Rapid treatment of dermatomyositis improved the patient’s quality of life and enabled him to support specific cancer treatments. This can be used as an element of early diagnosis and monitoring after treatment.

Context: Malignant melanoma of the mucous membranes of the nasopharynx is extremely rare. Despite improved diagnostic capabilities, these lesions are often diagnosed at an advanced stage and the prognosis is poor, in part related to the high rate of recurrence and metastasis. Case Presentation: We report one (01) case of relapse of a malignant mucous melanoma of the nasopharynx, four (04) years after complete conjunctival resection in a fifty (50) year old woman. Before the signs of call for epistaxis, an X-ray workup performed showed a nasopharyngeal tumor, followed by surgical resection with bilateral cervical lymph node dissection. Histology reveals a malignant melanoma without lymph node involvement. Adjuvant radiotherapy was delivered. The control by emission of positron (PET) at six (06) months after the end of adjuvant treatment did not find any lesions. Conclusion: To our knowledge, this is the first case report of a diagnosis of nasopharyngeal melanoma after four (04) years of complete remission. In view of the aggressive high rate of recurrence and metastasis, close monitoring and radiological workup at the slightest sign of calling should be required. Thus, the diagnosis will be made at an early stage which could improve the prognosis.

Dermatomyositis (DM) is a rare autoimmune disease characterized by non-infectious inflammatory damage to the skin and the predominant muscles in the belts. It is believed to be associated with about one case per 1,000 nasopharyngeal carcinoma (NPC). This association has been described for the locally advanced stage, stage II and stage III of the NPC. Little described in the early stages (stage I), its symptomatology is often indicative of cancer whose diagnosis is based on five criteria: muscle weakness of the proximal limbs, elevation of serum muscle enzymes, histological muscle abnormalities in muscle biopsy, electromyographic abnormality and clinical inflammatory dermatological manifestation. Treatment is based on corticosteroid therapy and etiological treatment of cancer. The prognosis of NPC in patients with paraneoplastic DM is comparable to non-infected patients. We report this case of DM revealing an early stage NPC and we take stock of the state of knowledge about paraneoplastic DM associated with rarely described NPC. Indeed, in Morocco the last description of a case dates back to 2016.