DERMATOMYOSITIS and polymyositis are diffuse inflammatory disorders of skeletal muscles that cause weakness of proximal muscle groups. When skin changes occur in addition to muscle involvement, the term "dermatomyositis" is used. Although general reference texts state that the heart can be involved in polymyositis and dermatomyositis, only six cases of myocardial involvement have been reported. Four of these six patients had well-documented pathologic changes in the myocardium.1-4Our patient had dermatomyositis with severe, diffuse myocarditis and a malignant carcinoid tumor. Malignant tumors are frequently found in patients with dermatomysitis and polymyositis, but to our knowledge, no previous cases have been reported in association with the carcinoid syndrome. Report of a Case A 48-year-old man began to experience difficulty climbing stairs and had a diffuse, erythematous rash eight years before admission. Biopsy specimens of the skin and of the deltoid and quadriceps femoris muscles showed chronic inflammation, necrosis of muscle