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Objective: Compared to the general population, malignancy is more common in patients with systemic sclerosis (SSc) and is one of the leading causes of mortality. The objective of this study was to assess the frequency and types of malignancies, and its association with SSc features. Methods: Medical records of 141 patients who were followed up in the Department of Rheumatology at Kocaeli University Medical Faculty Hospital and who met the 2013 American College of Rheumatology/European League Against Rheumatism SSC classification criteria were retrospectively analyzed. Clinical, demographic, laboratory and radiological information of the patients were obtained from the patient files. Results: Of the seven cases with malignancy, two had non-small cell lung cancer, two had breast cancer, one had larynx cancer, one had endometrium cancer, and one had chondrosarcoma. Apart from malignancy, a female patient was diagnosed with monoclonal gammopathy of undetermined significance. Four of the patients diagnosed with malignancy were evaluated as limited, and three with diffuse skin involvement. Modified Rodnan skin score was significantly higher in SSc patients with malignancy than in the patients without malignancy (p=0.045). No significant difference was found in terms of disease subtype, gender, age, auto-antibody and disease duration. Conclusion: Since the risk of malignancy is increased in patients with SSc, patients should be followed carefully. Malignancy can be diagnosed before the onset of SSc, concurrently or during the follow-up. SSc can be seen as a paraneoplastic syndrome, especially in patients with positive anti-RNAP-III antibody, and these patients should be monitored in terms of malignancy. [ABSTRACT FROM AUTHOR]

Rheumatological differential diagnosis has been established in cases such as dry mouth, pain or swelling in the locomotor system, muscle weakness, fever, weight loss, Raynaud's phenomenon, lymphadenopathy, splenomegaly, skin stiffness and rash, which cannot be explained with an explicit reason. The idea that existing symptoms in a person with a clean oncological history may have been caused by disorganization of an occult cancer in the immune system is confusing for many clinicians. Rheumatologic complaints in a person with a history of cancer may be the primary tumor recurrence in the locomotor system, metastasis or a complication of previous treatment. Rapid increase in the size of the articular or periarticular structure in the follow-up, irregular boundary invasion of the surrounding structures, aggressive periosteal reaction and the presence of skin ulceration are the characteristics evoking malignancy. Radiotherapy, various chemotherapeutic agents and the rheumatic effects of hematological stem cell transplantation are worth mentioning. In patients whose medical histories do not indicate any malignancy, a newly developed local cancer, metastasis or paraneoplastic syndrome in the musculoskeletal system may present as a rheumatic disease. Rheumatic paraneoplastic syndrome is mainly characterized by carcinomatous polyarthritis, connective tissue diseases, Jaccoud's arthropathy, secondary Raynaud's phenomenon, vasculitis, palmar fasciitis and polyarthritis, hypertrophic osteoarthropathy, remitting seronegative symmetric synovitis and pitting edema, tumor-associated osteomalacia, reflex sympathetic dystrophy and eosinophilic fasciitis. One of the important issues to remember is that the current symptoms may have been due to a rheumatic disease associated with malignancy which is already present and has been unnoticed. Knowing that malignancy may be the underlying reason for rheumatic complaints through current knowledge and skepticism, the clinician may be able to make effective treatment of occult tumor with earlier diagnose. Therefore; if atypical symptoms occur rapidly and severely in patients over 50 years of age, the presence of malignancy should be ruled out before the primary rheumatologic diagnosis is established. [ABSTRACT FROM AUTHOR]

Otoimmün ensefalitler subakut başlangıçlı bellek bozukluğu, konfüzyon ve sık nöbetlerle karakterize paraneoplastik ya da immünolojik etyolojili bir grup sendromdur. Otoimmün limbik ensefalit tanılı hastaların neredeyse yarısında nöbetler, özellikle tedaviye dirençli nonkonvülzif nöbetler ve nonkonvülzif status epileptikus tabloları izlenmektedir. Otoimmün ensefalit düşünülen bir hastanın tanısı ve takibinde EEG önemli bir tanı aracıdır. Bu derlemenin amacı ilgili literatür ışığında otoimmün ensefalit ve paraneoplastik nörolojik sendromlarda sık karşılaşılan EEG özelliklerini gözden geçirmektir. Autoimmune encephalitis is a group of syndromes with subacute onset of amnesia, confusion and prominent seizures which may have paraneoplastic or immune-mediated etiology. Nearly half of the patients diagnosed with autoimmune limbic encephalitis have experienced seizures, prominently refractory nonconvulsive seizures and nonconvulsive status epilepticus. EEG is an important diagnostic tool in diagnosis and follow-up of the patients with autoimmune encephalitis. Here, we aim to review the EEG findings which were detected in the different autoimmun encephalitis and paraneoplastic neurological syndromes. [ABSTRACT FROM AUTHOR]

Oncogenic osteomalacia is a rarely seen paraneoplastic syndrome characterized by hypophosphatemic osteomalacia. Even though serum 1,25 (OH)2 vitamin D level is almost very low to be detected, 25 (OH) vitamin D level is normal. Alkaline phosphatase level is frequently high, however calcium and parathyroid hormon levels are normal. Majority of the tumours leading to the paraneoplastic syndrome with oncogenic osteomalacia patients are mesenchymally originated. Age of diagnosis is usually in the fourth decade however there are also reported cases under the age of 18 in the literature. Pain, gait abnormalities and loss of muscle strength seen in the patients can be as severe as to be misdiagnosed for muscle diseases. When the cases reported in the literature are evaluated it is seen that detection of the turnouts come about on average after 4 years of osteomalacia diagnosis. The most important aspect of the disease is unresponsiveness to osteomalacia treatment and recovery by only tumor resection. We propose that it is important for osteomalacia patients whom we come across frequently in the population, to be evaluated from the point of tumoral constitution during the follow up period especially for the ones who are resistant hypophosphatemic and to treatment. [ABSTRACT FROM AUTHOR]

Paraneoplastic dermatoses are diseases that may be associated with an internal malignancy. The awareness of paraneoplastic dermatoses among clinicians and pathologists is of great importance in early diagnosis and management of internal malignancy, in monitoring for tumor recurrence, and for clarifying the pathophysiology. The signs and symptoms of dermatological lesions are easily detectable, therefore, they may be the reason for a cancer patient to refer to a physician. Cutaneous paraneoplastic syndromes usually have a course parallel to the underlying malignancy. In this review, the most common cutaneous paraneoplastic syndromes are overviewed. [ABSTRACT FROM AUTHOR]

Thromboembolic events (TEE) may occur in cancer patients 15 % and 30-50 % in clinical and post mortem settings, respectively. Migrating TEE which may be seen as a paraneoplastic syndrome in these patients are defined as Trousseau syndrome. A heavy smoker 50-years old man experienced multiple embolectomies and amputations due to recurrent TEE in a period of 4 months. A thoracentesis was done due to right-sided massive pleural effusion and it was reported as malignant cytology. Histopathologic examination of the excisional biopsy of the right axillary lymphadenopathy was reported as metastasis of the pulmonary adenocarcinoma. As a conclusion, Trousseau syndrome is frequently seen in cancer patients, but is rarely reported. Our case is presented here once more to emphasize the importance of early diagnosis and the necessity of investigating the underlying malign diseases in case of the failure of anticoagulant treatment. [ABSTRACT FROM AUTHOR]

We report a case of paraneoplastic encephalitis associated with anti-Ma2 antibodies. Medical history and thorax computed tomography findings suggested malignant mesothelioma. Pleural biopsy results were compatible with high-grade neoplastic infiltration. Although the biopsy could not differentiate the type of neoplasm, mesothelioma was considered a strong possibility in this poorly differentiated lung carcinoma. To the best of our knowledge this is the first case report of paraneoplastic encephalitis associated with anti-Ma2 antibodies and mesothelioma. [ABSTRACT FROM AUTHOR]

Paraneoplastic limbic encephalitis (PLE) is a result of an autoimmune reaction in patients who have an apparent or an occult malignancy. Patients often present to hospitals with subacute psychiatric symptoms, memory disturbances and epileptic seizures. Diagnosis was made by the elimination of other possibilities presenting similar symptomatology, cerebral radiologic findings, EEG and CSF examination and most importantly detecting the primary tumor. Our case presented to hospital with multiple epileptic seizures, confusion, and was diagnosed as PLE after radiologic, electrophysiologic and laboratory examination. We thougt that it is worth to report this rare case and discuss it under the light of literature. [ABSTRACT FROM AUTHOR]

A 68-year-old woman presented with subacute onset of limbic symptoms, cerebellar ataxia and polyneuropathy. While the initial findings were suggestive of a paraneoplastic syndrome, she later developed liver and kidney problems during the follow-up. The patient was finally diagnosed as having definite systemic lupus erythematosus (SLE) based on clinical and serological findings. She made a remarkable recovery following treatment with prednisolone and cyclophosphamide. This is the first occurrence of simultaneous involvement of the peripheral nerves and cerebellum in a SLE patient. [ABSTRACT FROM AUTHOR]