Rheumatic syndromes and occult tumor: 10-year experience in a teaching hospital

Reumatol Clin (Engl Ed). 2020 Jan-Feb;16(1):42-44. doi: 10.1016/j.reuma.2018.01.006. Epub 2018 Feb 16.
[Article in English, Spanish]

Abstract

Objective: To describe the different clinical characteristics of patients admitted to the Rheumatology Department due to rheumatic manifestations as the first expression of an unknown malignant process.

Patients and methods: Retrospective and descriptive observational study involving the review of the medical records of those admitted to rheumatology in the University Hospital of Ciudad Real between January 2007 and August 2017 for initial rheumatic manifestations with a suspicion at discharge of an unknown tumor.

Results: In all, 64 patients were identified from more than 500 admissions. The most common rheumatic manifestations were inflammatory low back pain, polyarthralgia, hip pain, thoracic spine pain, cervical pain, polyarthritis and polymyalgia rheumatica. Forty-four percent had low hemoglobin, 70% had elevation of acute-phase reactants, 62% had abnormal tumor markers, 76% had metastatic lesions. In 20% the primary tumor was of pulmonary origin and only 26.56% received palliative treatment; 64% died.

Discussion: It is important to consider the possibility of an underlying malignant process in the differential diagnosis since its early identification can be determinant for prognosis.

Keywords: Diagnóstico diferencial; Differential diagnosis; Hidden tumor; Manifestaciones reumáticas; Prognosis; Pronóstico; Rheumatic manifestations; Tumor oculto.

Publication types

  • Observational Study

MeSH terms

  • Acute-Phase Proteins / analysis
  • Aged
  • Anemia / etiology
  • Arthralgia / etiology
  • Arthritis / etiology
  • Biomarkers, Tumor / blood
  • Female
  • Hospitals, University
  • Humans
  • Low Back Pain / etiology
  • Male
  • Neck Pain / etiology
  • Neoplasms, Unknown Primary / blood
  • Neoplasms, Unknown Primary / complications*
  • Neoplasms, Unknown Primary / diagnosis
  • Neoplasms, Unknown Primary / mortality
  • Polymyalgia Rheumatica / etiology
  • Retrospective Studies
  • Rheumatic Diseases / blood
  • Rheumatic Diseases / etiology*
  • Syndrome
  • Time Factors

Substances

  • Acute-Phase Proteins
  • Biomarkers, Tumor