Watson Geoffrey Alan, O'Neill Lorraine, Law Ruth, McCarthy Geraldine, Veale Douglas
St. Vincent's University Hospital, Dublin, Ireland.
Mater Misericordiae University Hospital, Dublin, Ireland.
Case Rep Oncol Med. 2015;2015:934039. doi: 10.1155/2015/934039. Epub 2015 Oct 19.
Malignant disease may be associated with a wide variety of musculoskeletal syndromes. Rarely the musculoskeletal system can be indirectly affected by paraneoplastic phenomena, such as carcinomatous polyarthritis (CP). The differential diagnosis for CP is broad and is often a diagnosis of exclusion. CP often presents similarly to other forms of inflammatory arthritis, and a detailed history and physical examination can often distinguish CP from other more common causes of polyarticular arthritis. However serological tests such as rheumatoid factor (RF) and anti-citrullinated peptide (anti-CCP) antibody positivity, while rare, can be misleading. Clinical awareness and suspicion are paramount in achieving an accurate diagnosis and early detection of an occult neoplasm is critical for prompt management and therapy. We report two cases presenting with this unique clinical phenotype associated with paraneoplastic polyarthropathy and review the literature.
恶性疾病可能与多种肌肉骨骼综合征相关。肌肉骨骼系统很少会受到副肿瘤现象的间接影响，如癌性多关节炎（CP）。CP的鉴别诊断范围广泛，通常是排除性诊断。CP的表现通常与其他形式的炎性关节炎相似，详细的病史和体格检查往往可以将CP与多关节性关节炎的其他更常见病因区分开来。然而，类风湿因子（RF）和抗瓜氨酸化肽（抗CCP）抗体阳性等血清学检测虽然少见，但可能会产生误导。临床意识和怀疑对于准确诊断至关重要，早期发现隐匿性肿瘤对于及时管理和治疗至关重要。我们报告了两例表现出这种与副肿瘤性多关节病相关的独特临床表型的病例并对文献进行了综述。
