Paraneoplastic arthritis — at the crossroads of rheumatology and oncology

Paraneoplastic arthritides (PA) are a group of inflammatory arthropathies associated with latent or manifest malignancy, localized in a distant site in relation to the primary focus and caused by immune-mediated mechanisms. Although the pathogenesis of PA is unknown, immune-mediated mechanisms can cause paraneoplastic syndrome with a dominant feature of polyarthritis. Arthritis can be both the initial manifestation of the disease, and it can manifest itself some time before the oncological process. Common forms of PA include paraneoplastic oligo/polyarthritis; hypertrophic osteoarthropathy; remitting seronegative symmetric synovitis with pitting edema; palmar fasciitis and pancreatic panniculitis associated with pancreatic carcinoma. The purpose of this review article was to describe the clinical characteristics, diagnostic assessment and treatment of paraneoplastic arthritis, and highlight the challenges that healthcare professionals may face in order to distinguish these conditions from other autoimmune rheumatic diseases. Further research is needed to understand the mechanisms associated with PA and to develop new diagnostic biomarkers.