[Polymyalgia rheumatica revealing a lung cancer]
K Cocquempot1, G Defuentes, S Duron-Martineau
1Service de médecine interne, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France. k.cocquempot@gmail.com
Revue Des Maladies Respiratoires
|January 16, 2013
Summary
Polymyalgia rheumatica can be a paraneoplastic syndrome linked to lung cancer. Early diagnosis and treatment of the underlying malignancy are crucial for managing these rheumatic symptoms.
Area of Science:
- Rheumatology
- Oncology
- Internal Medicine
Background:
- Polymyalgia rheumatica (PMR) is a common inflammatory condition in the elderly, affecting connective tissues.
- PMR has been previously associated with malignant tumors, presenting as a paraneoplastic syndrome.
- This association highlights the importance of considering occult malignancies in PMR diagnosis.
Observation:
- Two patients, a 63-year-old woman and a 58-year-old man, presented with severe proximal girdle pain and elevated inflammatory markers, consistent with PMR.
- Standard analgesic and anti-inflammatory treatments were ineffective for their rheumatic symptoms.
- Further investigation revealed underlying lung adenocarcinoma in both cases.
Findings:
- The paraneoplastic rheumatic manifestations in both patients responded effectively to chemotherapy targeting the lung adenocarcinoma.
- This case series and literature review underscore diagnostic challenges in paraneoplastic PMR.
- Therapeutic resistance and atypical features in PMR may indicate an underlying occult malignancy.
Implications:
- Clinicians should consider paraneoplastic syndromes, particularly lung cancer, in elderly patients with PMR, especially if initial treatments fail.
- Early detection and management of the primary malignancy are essential for resolving paraneoplastic PMR.
- This emphasizes the need for a comprehensive diagnostic approach in suspected paraneoplastic PMR cases to avoid diagnostic delays.
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