Remitting Seronegative Symmetrical Synovitis with Pitting Oedema as the First Manifestation of an Adenocarcinoma of the Caecum

  • Edgar Pratas Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, and Medical Oncology Department, Instituto Português Oncologia de Coimbra Francisco Gentil E. P. E., Coimbra, Portugal
  • João Carvalho Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, and Medical Oncology Department, Instituto Português Oncologia de Coimbra Francisco Gentil E. P. E., Coimbra, Portugal
  • Isabel Domingues Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, and Medical Oncology Department, Instituto Português Oncologia de Coimbra Francisco Gentil E. P. E., Coimbra, Portugal
  • João Fonseca Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Teresa Carvalho Medical Oncology Department, Instituto Português Oncologia de Coimbra Francisco Gentil E. P. E., Coimbra, Portugal
  • Gabriela Sousa Medical Oncology Department, Instituto Português Oncologia de Coimbra Francisco Gentil E. P. E., Coimbra, Portugal
  • Manuel Teixeira Veríssimo Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

Keywords

RS3PE, paraneoplastic, adenocarcinoma, cecum

Abstract

Remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) is a rare syndrome that affects the elderly. Although the aetiology is not fully understood, it has been related to multiple diseases including cancer. We present the case of an 80-year-old man with a full spectrum of signs and symptoms compatible with RS3PE: sudden onset of bilateral polyarthralgia of the metacarpophalangeal and proximal interphalangeal joints, oedema of the dorsum of the hands, increased inflammatory markers and seronegative rheumatoid factor. After a 5-day course of corticotherapy, the patient became asymptomatic although maintaining a mild anaemia. During a search for the underlying cause of the RS3PE, an early stage adenocarcinoma of the caecum was diagnosed and surgically removed. No further treatment was performed and after 3 years of follow-up the patient remains without evidence of either paraneoplastic RS3PE or cancer.

References

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  • Published: 2018-11-22

    Issue: LATEST ONLINE (view)

    Section: Articles

    How to cite:
    Pratas, E., Carvalho, J., Domingues, I., Fonseca, J., Carvalho, T., Sousa, G., & Veríssimo, M. (2018). Remitting Seronegative Symmetrical Synovitis with Pitting Oedema as the First Manifestation of an Adenocarcinoma of the Caecum. European Journal of Case Reports in Internal Medicine, 2. https://doi.org/https://doi.org/10.12890/2018_000976