Paraneoplastic rheumatic syndromes.

Area of Science:

• Rheumatology
• Oncology
• Internal Medicine

Background:

• Malignant neoplasms are linked to diverse paraneoplastic rheumatological syndromes.
• Commonly observed syndromes include hypertrophic osteoarthropathy, carcinoma polyarthritis, dermatomyositis/polymyositis, and paraneoplastic vasculitis.
• Less frequent associations involve fasciitis, panniculitis, erythema nodosum, Raynaud's syndrome, digital gangrene, erythromelalgia, and lupus-like syndromes.

Purpose of the Study:

• To highlight the association between rheumatological syndromes and underlying malignancies.
• To emphasize the importance of recognizing non-metastatic symptoms as potential indicators of occult cancer.
• To guide early diagnosis and management of paraneoplastic rheumatic disorders.

Main Methods:

• Review of literature on paraneoplastic rheumatological syndromes associated with malignant neoplasms.
• Clinical observation of musculoskeletal manifestations preceding, coinciding with, or following cancer diagnosis.
• Identification of key rheumatic symptoms suggestive of underlying cancer.

Main Results:

• Musculoskeletal symptoms can precede, coincide with, or follow cancer diagnosis, and may indicate recurrence.
• The course of rheumatic disorders often parallels the primary tumor's progression.
• Successful treatment of the underlying malignancy frequently leads to regression of the rheumatic syndrome.

Conclusions:

• Awareness of paraneoplastic rheumatological syndromes is vital for detecting hidden cancers.
• Specific rheumatic manifestations like rapid inflammatory arthritis, bone pain in older adults, vasculitis, fasciitis, unresponsive Raynaud's syndrome, digital gangrene, or Lambert-Eaton myasthenic syndrome warrant investigation for malignancy.
• Management involves treating the primary cancer and providing symptomatic relief for rheumatic symptoms.