Generalized edema as the initial manifestation of Anti-TIF1γ-positive dermatomyositis associated with ovarian cancer.

Generalized edema is an uncommon manifestation of dermatomyositis (DM) and may lead clinicians to consider alternative systemic conditions. Anti-transcriptional intermediary factor 1 gamma (TIF1γ) antibodies are associated with an increased risk of malignancy and dysphagia in patients with DM. We report an 82-year-old woman with anti-TIF1γ-positive DM who initially presented with generalized edema, followed by progressive dysphagia and proximal muscle weakness. Skin manifestations, anti-TIF1γ antibody positivity, electromyography, muscle magnetic resonance imaging, and muscle biopsy established the diagnosis of DM. Subsequent malignancy screening identified ovarian cancer. Despite immunotherapy, severe dysphagia persisted and required prolonged nasogastric tube feeding. This case highlights generalized edema as an early manifestation of anti-TIF1γ-positive DM and suggests that it may precede more typical manifestations of the disease, potentially leading to diagnostic delay.