Manifestations rhumatologiques paranéoplasiques en dehors de l'ostéoarthropathie hypertrophiante

Abstract

Paraneoplastic rheumatic syndromes (PRS), as any paraneoplastic syndrome, induce signs or symptoms related to a known or an unrecognized tumour, cancer, or haemopathy, often malignant but not always. The chronologic relationship between the neoplastic process and the symptomatology is essential. PRS is not due to a tumour-induced compression or a synovial or bone peri-articular metastatic invasion. They differ from pre-neoplastic systemic rheumatic conditions. They disappear when the patient may benefit from a radical treatment. The best rheumatologic example is the hypertrophic pneumogenic osteoarthropathy described elsewhere in this work. Here we review the other PRS conditions: the palmar fasciitis syndrome; the ovary (but not exclusively) polyarthritis and cancer; the paraneoplastic muscular syndromes induced by a dermatomyositis, polymyositis, Lambert-Eaton myasthenia syndrome, and stiff man syndrome; inflammatory rheumatisms (polyarthritis, pseudo Still's disease, benign oedematous acute polyarthritis of the elderly, rhizomelic pseudoarthritis) in their rare paraneoplastic presentations; the vascular lesions (erythromelalgia, Raynaud's disease, digital necrosis, vascularitis) in their paraneoplastic presentations; other potentially paraneoplastic systemic rheumatic conditions (atrophic polychondritis, multicentric reticuloendotheliosis, panniculitis-arthritis syndrome, and amyloid arthropathy); paraneoplastic hypercalcemias, in particular those related to the parathormone-related peptide; and oncogenous osteomalacia. Clinical and paraclinical orientations are considered, according to these different situations, particularly for the presented tumoural and haematological diseases.