Malignancy in Rheumatic Disease: Interrelationships

Abstract

Patients with inflammatory arthritis and malignancy comprise two distinct populations. One group represents the chance occurrence of malignancy and rheumatic disease. These patients have symmetric polyarthritis, chiefly classic rheumatoid arthritis, and react positively to the rheumatoid factor test. There is no temporal relationship between tumor onset and rheumatic disease onset. In the second group, there may be a causal relationship between the malignancy and the rheumatic disease. These patients have asymmetric rather than symmetric arthritis and test results are negative for rheumatoid factor. There is a close temporal relationship between the onset of the tumor and the onset of the rheumatic disease. The mortality rate is significantly higher than in patients with symmetric polyarthritis. In 80 percent of women with asymmetric arthritis and malignancy, the tumor is mammary carcinoma. This indicates the advisability of a careful breast examination in this group of women.

Paraneoplastic rheumatic syndromes: report of eight cases and review of literature

“…Erythrocyte sedimentation rate was very high, as usual during the PMR and the evolution was favorable under corticosteroid therapy. For these authors, PMR associated with cancers are unusual but they can always justify a precautionary approach [14]. In our patient, the PMR was not associated with Horton's disease.…”

“…The question of possible paraneoplastic process however remains open. Sheon et al [14] reported five cases of patients whose cancer was discovered in 3 months following the occurrence of PMR. It was a blood disease, cancers of the colon, prostate, ovary, and kidney.…”

Polymyalgia Rheumatica and Breast Cancer

“…3 The malignancies most often reported to present as PMR include cancers of the colon, lung, kidney, and prostate as well as leukemia and lymphoma. 1,3,8 Although 13 cases of giant cell arteritis affecting the breast have been reported, 9 only one case of PMR presenting at the same time as breast cancer has been reported. 6 The 2 diagnoses were felt to be coincidental given the patient's age.…”

Paraneoplastic rheumatic syndromes

“…Probably the earliest attention to paraneoplastic syndromes and arthritis appears with the publication by Sheon et al [6]. They reviewed the incidence of cancer over an 8.5-year period at the Toledo Clinic.…”