Dermatomyositis (DM) is known to be associated with underlying malignancy, though the strength of this relationship and its predisposing factors are not clearly defined. We present a case of a patient who was first diagnosed with DM and, subsequently, metastatic esophageal adenocarcinoma. Despite aggressive immunosuppressive therapy, the patient's cutaneous eruption failed to resolve and his muscle weakness progressed. He had respiratory failure and died less than 2 months after his initial presentation. To our knowledge, this is only the second case of metastatic esophageal adenocarcinoma associated with DM reported in the English language literature.

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