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Carcinomatous Polyarthritis

Polyarthritis can rarely (<2%) be the presenting manifestation of an occult malignancy. The association of polyarthritis and malignancy is suggested by:

  • A close temporal relationship (less than one year) between the onset of a seronegative arthritis and the diagnosis of malignancy.

  • Improvement of the arthritis with treatment of the underlying cancer.

  • Recurrence of the arthritis with tumor recurrence.

Carcinomatous polyarthritis should be strongly suspected in a patient with the following features:

  • Explosive onset of an asymmetric oligoarthritis or polyarthritis

  • Late age of onset

  • Predominant lower extremity involvement

  • Spares the wrists and small hand joints

  • Absence of rheumatoid factor

  • Erosions or rheumatoid nodules

Radiographs show no periosteal reaction. Note that polymyalgia rheumatica-like symptoms unresponsive to prednisone have also been described as a presentation of various malignancies.


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Web:

Rheumatology and Oncology Bulletin of the NYU Hospital for Joint Diseases

Migratory Polyarthritis as a Paraneoplastic Syndrome - NCBI

Case Reports in Oncological Medicine


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