A 77-year-old male with a history of Agent Orange and asbestos exposure and a 22 pack/year history of smoking presented with progressive proximal muscle weakness 8 days after diagnosis of malignant mesothelioma with sarcomatoid features. The clinical diagnosis of paraneoplastic polymyositis was made, and the patient responded to treatment with steroids. Review of the literature shows no previously described association between polymyositis and mesothelioma. We present a discussion of the association of malignancy and inflammatory myopathies, the paraneoplastic syndromes associated with mesothelioma, and the postulated pathophysiology of paraneoplastic inflammatory myopathy.
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