Hepatocellular Carcinoma-Associated Polymyositis Presenting With Unilateral Upper Limb Subcutaneous Edema

Abstract

Inflammatory myopathy is characterized by proximal muscle weakness which is highly suspected through an autoimmune pathogenesis. Extramuscular manifestations including fever, arthralgia, and pulmonary complications are common. 1 Diagnosis of both polymyositis (PM) and dermatomyositis (DM) relies on characteristic clinical manifestations, increased serum muscle enzymes, and a standard electromyography (EMG). Periorbital edema is often accompanied by a heliotrope rash. 1 However, subcutaneous edema in limbs is extremely rare. A literature search uncovered 33 cases of limb edema associated with inflammatory myopathy, of whom seven were localized edema, while the remaining were considered generalized edema. All seven patients with localized edema were diagnosed with DM. In this article, we report on a case of PM with localized subcutaneous edema and hepatocellular carcinoma (HCC). To the best of our knowledge, this is the first case of localized edema to be associated with PM.