Paraneoplastic Anti-transcriptional Intermediary Factor 1γ (Anti-TIF1γ)-Positive Dermatomyositis Presenting as Dropped Head Syndrome: A Case Report.

Anti-transcriptional intermediary factor 1γ (anti-TIF1γ) antibody-positive dermatomyositis is a rare but significant subtype of dermatomyositis, often associated with malignancy. We present a case of a 66-year-old male with a history of heavy smoking, who was diagnosed with a locally advanced squamous cell carcinoma of the right cervical lymph nodes. After treatment with chemoradiotherapy, he developed dropped head syndrome and muscle weakness and was found to have elevated anti-TIF1γ antibodies, suggestive of paraneoplastic myositis. Despite aggressive treatment, the patient's condition deteriorated, leading to recurrent carcinoma and, ultimately, death due to respiratory infection. The rarity of this presentation and the diagnostic challenges are discussed, emphasizing the role of TIF1γ antibodies in diagnosing this rare entity.