Rheumatic manifestations of neoplasia

Neoplasia can be associated with a wide range of rheumatologic manifestations. Literature over the last 12 months has reviewed metastasis of solid tumors to the joint and hypertrophic pulmonary osteoarthropathy. Vasculitis has been reported as a paraneoplastic syndrome associated with both hematologic and solid malignancies. Paraproteinemia occurs in association with rheumatoid arthritis and may progress to lymphoproliferative malignancy. A careful review of 23 rheumatoid arthritis patients with a serum paraprotein has attempted to study the predictive value of monoclonal gammopathy in rheumatoid arthritis for the later development of lymphoproliferative malignancy. Rheumatic manifestations, including cutaneous vasculitis and lupuslike syndromes, are seen in up to 10% of patients with myelodysplastic syndromes. Leukemias sometimes present as synovitis, and immunocytologic analysis of joint fluids can help to establish the diagnosis of leukemic arthritis at an early stage. Several other cases reports of arthritis associated either directly or indirectly with neoplasia are presented.