Palmar fasciitis and arthritis with malignant neoplasms: A paraneoplastic syndrome

VARIETY of musculoskeletal syndromes have been associated with malignancy.’ Among these, hypertrophic pulmonary osteoarthropathy, dermatomyositis, and carcinomatous polyarthritis are the most frequently recognized.‘** Shoulder-hand syndrome, a variant of reflex sympathetic dystrophy, is another rheumatic disorder that has occasionally been associated with malignant neoplasms.3-‘5 Although brain and lung malignancies are the tumors most frequently associated with this syndrome,6*7,9-‘3 carcinoma of the bladder,8*14 uterus,15 breast,‘*” and esophagus, ‘*I4 have also been reported. Recently, a syndrome that has been termed “palmar fasciitis and arthritis” has been reported to occur in association with ovarian adenocarcinoma.3 This disorder differs from the usual case of shoulder-hand syndrome in that the progression and extent of rheumatic disease are much more dramatic. Specifically, the fasciitis is more severe, the arthritis more inflammatory, and both are more rapidly progressive than generally seen in shoulder-hand syndrome. Com