RS3PE: A Rheumatic Presentation of Lung Malignancy

We describe a previously well 56-year-old man who presented with symmetrical inflammatory polyarthralgia associated with bilateral lower limb swelling and left hand puffiness. He had noticed blood steaks in his productive cough for half a year but reported no constitutional symptoms. Inflammatory ma...

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Main Authors: Chester Yan Hao Ng, Chrystie Wan Ning Quek, Yi Ting Lim, Jiacai Cho
Format: Article
Language:English
Published: American College of Physicians 2023-07-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2022.0983
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author Chester Yan Hao Ng
Chrystie Wan Ning Quek
Yi Ting Lim
Jiacai Cho
author_facet Chester Yan Hao Ng
Chrystie Wan Ning Quek
Yi Ting Lim
Jiacai Cho
author_sort Chester Yan Hao Ng
collection DOAJ
description We describe a previously well 56-year-old man who presented with symmetrical inflammatory polyarthralgia associated with bilateral lower limb swelling and left hand puffiness. He had noticed blood steaks in his productive cough for half a year but reported no constitutional symptoms. Inflammatory markers were elevated, whereas rheumatoid factor was negative. Imaging of the chest showed a mass in the right upper zone, which was confirmed via biopsy to be ALK-positive lung adenocarcinoma. The patient was diagnosed with paraneoplastic remitting seronegative symmetrical synovitis with pitting edema, representing one of the first descriptions of lung adenocarcinoma–associated RS3PE.
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series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-56bc04cfc15642e5bd4bf349087b9d272025-08-20T02:13:01ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642023-07-012710.7326/aimcc.2022.0983RS3PE: A Rheumatic Presentation of Lung MalignancyChester Yan Hao Ng0Chrystie Wan Ning Quek1Yi Ting Lim2Jiacai Cho31Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore1Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore2Department of Diagnostic Imaging, National University Hospital, Singapore1Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, SingaporeWe describe a previously well 56-year-old man who presented with symmetrical inflammatory polyarthralgia associated with bilateral lower limb swelling and left hand puffiness. He had noticed blood steaks in his productive cough for half a year but reported no constitutional symptoms. Inflammatory markers were elevated, whereas rheumatoid factor was negative. Imaging of the chest showed a mass in the right upper zone, which was confirmed via biopsy to be ALK-positive lung adenocarcinoma. The patient was diagnosed with paraneoplastic remitting seronegative symmetrical synovitis with pitting edema, representing one of the first descriptions of lung adenocarcinoma–associated RS3PE.https://www.acpjournals.org/doi/10.7326/aimcc.2022.0983
spellingShingle Chester Yan Hao Ng
Chrystie Wan Ning Quek
Yi Ting Lim
Jiacai Cho
RS3PE: A Rheumatic Presentation of Lung Malignancy
Annals of Internal Medicine: Clinical Cases
title RS3PE: A Rheumatic Presentation of Lung Malignancy
title_full RS3PE: A Rheumatic Presentation of Lung Malignancy
title_fullStr RS3PE: A Rheumatic Presentation of Lung Malignancy
title_full_unstemmed RS3PE: A Rheumatic Presentation of Lung Malignancy
title_short RS3PE: A Rheumatic Presentation of Lung Malignancy
title_sort rs3pe a rheumatic presentation of lung malignancy
url https://www.acpjournals.org/doi/10.7326/aimcc.2022.0983
work_keys_str_mv AT chesteryanhaong rs3pearheumaticpresentationoflungmalignancy
AT chrystiewanningquek rs3pearheumaticpresentationoflungmalignancy
AT yitinglim rs3pearheumaticpresentationoflungmalignancy
AT jiacaicho rs3pearheumaticpresentationoflungmalignancy