Occult ovarian adenocarcinoma manifesting as dermatomyositis

A woman in her 60s presented with erythematous lesions predominantly over the joints. After evaluation by dermatology and rheumatology, she was diagnosed with dermatomyositis and initiated on oral steroids and immunosuppressants. She was subsequently referred to gynaecology services for further evaluation of possible malignancies. On pelvic examination, a firm, mobile mass was noted in the right adnexa which was confirmed on imaging. A decision for staging laparotomy was taken. Intraoperatively, a solid mass was observed in the right ovary with no adjacent tumour deposits. Histopathology indicated high-grade serous carcinoma. Following surgery, her dermatological condition improved drastically, and she is currently off medications. She has received postoperative chemotherapy. Five years on, she is doing well.