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Metastatic prostate cancer mimicking polymyalgia rheumatica
Charles T Randazzo1, Aaron W Bernard, Douglas A Rund
1Department of Emergency Medicine, The Ohio State University Medical Center, 4833 Cramblett Hall, 456 W. 10th Avenue, Columbus, OH 43210, USA.
Case Reports in Emergency Medicine
|January 18, 2013
Summary
A man with muscle pain initially diagnosed with polymyalgia rheumatica (PMR) was found to have metastatic prostate cancer. This case highlights the importance of considering malignancy in patients presenting with PMR-like symptoms.
Area of Science:
- Rheumatology
- Oncology
- Emergency Medicine
Background:
- Polymyalgia rheumatica (PMR) is an inflammatory condition characterized by muscle pain and stiffness.
- Elevated inflammatory markers like erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are common in PMR.
- Metastatic prostate cancer can present with symptoms mimicking rheumatologic diseases.
Observation:
- A 59-year-old male presented with a four-month history of progressive proximal muscle pain and weakness.
- Initial investigations revealed elevated ESR and CRP, leading to a diagnosis of PMR.
- During hospitalization, metastatic prostate cancer was discovered and suspected as the cause of the patient's symptoms.
Findings:
- The patient's PMR-like syndrome was ultimately attributed to metastatic prostate cancer.
- This case underscores the potential overlap in presentation between rheumatologic conditions and advanced malignancies.
- Prompt recognition of this resemblance is crucial for accurate diagnosis.
Implications:
- Emergency physicians should consider underlying malignancies in patients presenting with symptoms suggestive of polymyalgia rheumatica.
- Differentiating between rheumatologic diseases and cancer symptoms requires a high index of suspicion.
- Integrating oncologic awareness into the diagnostic approach for inflammatory syndromes can improve patient outcomes.
