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Paraneoplastic rheumatic syndromes.

A G Fam1

  • 1Division of Rheumatology, Sunnybrook Health Science Centre, University of Toronto, Toronto, Ontario, Canada.

Bailliere'S Best Practice & Research. Clinical Rheumatology
|September 14, 2000
PubMed
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Cancer can trigger various rheumatological syndromes, often mimicking other conditions. Recognizing these paraneoplastic rheumatic disorders is crucial for early cancer diagnosis and treatment.

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:

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  • 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.