Malignancy dominated with rheumatic manifestations: A retrospective single-center analysis

Area of Science:

• Rheumatology
• Oncology
• Internal Medicine

Background:

• Paraneoplastic rheumatic syndromes present with rheumatic symptoms unrelated to direct tumor invasion.
• These syndromes are associated with an underlying malignancy, often diagnosed concurrently or shortly after rheumatic disease onset.

Purpose of the Study:

• To characterize the clinical features and malignancy risk factors in patients with paraneoplastic rheumatic syndromes.
• To emphasize the importance of screening for occult malignancies in patients presenting with rheumatic disorders.

Main Methods:

• Retrospective review of 21 patients diagnosed with paraneoplastic rheumatic syndromes.
• Analysis of clinical manifestations, demographic data, and associated malignancies.

Main Results:

• The study included 21 patients (11 men, 10 women, mean age 56.3 years) diagnosed with malignancy within two years of rheumatism diagnosis.
• Common findings included arthritis (48%), lymphadenopathy (38%), skin rash (38%), weight loss (29%), fever (24%), fatigue (24%), and myalgia (24%).
• Solid tumors were more prevalent (62%) than hematological malignancies. Antibody testing showed positive anti-nuclear antibody (ANA) in 38% and rheumatoid factor (RF) in 43%, with negative anti-extractable nuclear antigen (ENA) antibodies in most.

Conclusions:

• Rheumatic disorders in older patients with nonspecific systemic symptoms warrant investigation for occult malignancy.
• Close monitoring of patients with rheumatic disease is essential for early detection of associated cancers, particularly within the first two years of diagnosis.