Gall S, Tsiami S, Braun J. [Polymyalgic complaint: is there a tumor behind it?].
Dtsch Med Wochenschr 2020;
145:1253-1257. [PMID:
32838467 DOI:
10.1055/a-1173-2726]
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Abstract
HISTORY
A 61-year-old caucasian male presenting with pain in arms and thighs, weight loss of 10 kg in the last 3 months, and subfebrile temperatures, also had abdominal pain. In addition, he reported that his abdominal circumference had increased over the last two years.
FINDINGS AND DIAGNOSIS
Based on patient's complaints and the presence of elevated inflammatory markers in the absence of specific antibodies or peripheral synovitis a clinical diagnosis of polymyalgia rheumatica was made. The patient had an immediate clinical response to 20 mg prednisone/day, and inflammatory markers normalized. An abdominal MRI showed no signs of polymyalgia rheumatica but revealed a lipomatous mass with displacement of the adjacent intraabdominal and intrapelvine organs. Histologically a highly differentiated retroperitoneal liposarcoma was described.
THERAPY AND COURSE
The patient underwent a complete resection of the tumor. Because the liposarcoma was highly differentiated, the oncologists were reluctant to use any additional therapy.
CONCLUSIONS
The diagnostic work up of polymyalgic complaints should also include rare paraneoplastic diseases.
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