Paraneoplastic Rheumatic Syndromes

Overview

Malignant tumours may be associated with paraneoplastic rheumatic syndromes which developwithout direct invasion of tumour cells into tissues and are caused by humoral mediators. A numberof these syndromes was described – the most frequent ones include hypertrophic osteoarthropathy,carcinomatous polyarthritis, dermatomyositis and paraneoplastic vasculitis. Less frequently fascitis,Raynaud’s syndrome, digital gangrene, erythromelalgia,Lambert-Eaton’smyasthenia andothersare encountered. The list of rheumatic syndromes associated with malignant processes is extendingsteadily and recently in this group also benign oedematous polysynovitis, neutrophil dermatoses,osteomalacia and antiphospholipid syndrome are included.Musculoskeletal symptoms may developconcurrently with, before or after manifestation of the tumorous process and may also predict itsrecurrence. Clinical manifestations copy as a rule the course of the primary tumourous disease thetreatment of which frequently leads to disappaearance of rheumatic symptoms. Musculoskeletalmanifestations may draw attention to the presence of a latent tumorous process and make its earlydetection and initiation of therapy possible. The submitted paper reviews paraneoplastic rheumaticsyndromes and is concerned withmechanisms of their development, clinical picture andtherapeuticpossibilities.

Key words:
malignant tumours, rheumatic disease, paraneoplastic syndromes