Palmar fasciitis and polyarthritis syndrome associated with transitional cell carcinoma of the bladder

Paraneoplastic Palmar Fasciitis and Polyarthritis Syndrome in a Patient With Advanced Prostate Cancer

“…In most cases of PFPAS, the rheumatologic symptoms preceded the detection of the underlying malignancy, 1,3,5–11,15–18,20,21,23,26,28 whereas in some cases the PFPAS occurred simultaneously with 14,17,24 or after the initial cancer diagnosis. 2,4,6,19,22,29 It may also develop as the first symptom of cancer recurrence or progression (as was the case in our patient). 2,8,12,25,27,30,31 Indeed, in both cases of prostate cancer-related PFPAS, the rheumatologic symptoms appeared at the time of progression to the castration-resistant state.…”

“…1–9,12,14–20,22,24,25,29 ANA and rarely RF are the most common antibodies detected in PFPAS cases, suggesting a potential role for autoimmunity; however, these antibodies are not specific, are often present at low titers, 3,17,28 and may be found commonly in patients with cancer who do not show any signs or symptoms of rheumatologic disease. Therefore, the prototype of PFPAS seems to be a seronegative disorder.…”

“…1,7,23,25,28 However, in most cases, x-rays of the joints show no abnormalities (as was the case in our patient). 2,6,9,11,16,17,19,21,29 As the disease progresses, contractures develop and x-ray films of the hands may show flexion deformities of the MCP and PIP joints. 3,8,15 In some instances, PIP joints may be affected preferentially with relative sparing of MCP joints, although this is uncommon.…”

“…Since that seminal report published 30 years ago, only 48 additional cases of PFPAS have been described in the literature, and these have been associated with a number of different neoplasms, including gynecologic malignancies (ovarian and fallopian tube cancers), 2–16 pancreatic adenocarcinoma, 17–20 non—small cell and small cell lung carcinoma, 3,20–22 breast carcinoma, 23–26 prostate carcinoma, 27 gastric cancer, 28 colon cancer, 20 transitional cell carcinomas of the urinary tract, 6,20,29 carcinoma of unknown origin, 17 and hematologic malignancies 17,30 (Appendix Table 1). …”

Fallopian Tube Cancer with Palmar Fibromatosis or Fasciitis without Polyarthritis

“…The role of soluble stimulators of fibroblast activity such as transforming growth factor β (TGF-β) or connective tissue growth factor has been reported (5,23,24). However, because the relationship between Dupuytren's disease and TGF-β had also been shown (25), differences in the TGF-β levels cannot explain the different etiologies of palmar fibromatosis or fasciitis associated with cancer and Dupuytren's disease.…”