Perioperative management of anti-TIF1-γ dermatomyositis in a patient with breast cancer: a case report.

Dermatomyositis (DM) is a rare autoimmune disease, and its subtypes exhibit considerable heterogeneity in perioperative risk. The anti-transcription intermediary factor 1-gamma (TIF1-γ) antibody-positive subtype is particularly associated with an increased risk of underlying malignancy and poses unique anesthetic challenges because of its potential multisystem involvement. We report the perioperative anesthetic management of a 47-year-old woman with TIF1-γ antibody-positive DM complicated by breast cancer who underwent a modified radical mastectomy. The patient presented with classic cutaneous manifestations, proximal myopathy, and oropharyngeal dysphagia. Comprehensive pre-operative anesthetic assessment and meticulous perioperative management contributed to an uneventful surgical course and favorable outcome. This case highlights the marked clinical heterogeneity of DM subtypes and the corresponding differences in perioperative anesthetic risk. It also underscores the importance of recognizing the potential multisystem involvement of DM in patients undergoing anesthesia. Thorough pre-operative evaluation and individualized anesthetic management are therefore essential for optimizing perioperative outcomes.