Image of the Week: Which malignancy is the greatest risk for this patient?

A 60-year-old woman presents with a new nonpruritic rash and muscle weakness. She mentions having trouble carrying her groceries recently and getting up from the couch. Examination reveals an erythematous rash on her face, back, and neck, and violaceous papules on her eyelids and the joints of her fingers. Laboratory tests demonstrate positive antinuclear antibodies and an elevated serum creatine ...