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.

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References

  • McCarty DJ, O’Duffy JD, Pearson L, Hunter JB. Remitting seronegative symmetrical synovitis with pitting edema. RS3PE syndrome. JAMA 1985;254:2763–2767.
  • Li H, Altman RD, Yao Q. RS3PE: clinical and research development. Curr Rheumatol Rep 2015;17:49.
  • Arima K, Origuchi T, Tamai M, Iwanada N, Huang M, et al. RS3PE syndrome presenting as vascular endothelial growth factor associated disorder. Ann Rheum Dis 2005;64:1653–1655.
  • Tunc SE, Arslan C, Ayvacioglu NB, Sahin M, et al. Paraneoplastic remitting seronegative symmetrical synovitis with pitting edema (RS3PE syndrome): a report of two cases and review of the literature. Rheumatol Int 2004;24:234–237.
  • Vinci M, Malaguarnera L, Pistone G. RS3PE and ovarian cancer. Ann Rheum Dis 2001;60:429–430.
  • Sakamoto T, Ota S, Haruyama T, Ishihara M, Natsume M, Fukasawa Y, et al. A case of paraneoplastic remitting seronegative symmetrical synovitis with pitting edema syndrome improved by chemotherapy. Case Rep Oncol 2017;10:1131–1137.
  • Published: 2018-11-22

    Issue: Vol 5 No 12 (view)

    Section: Articles

    How to cite:
    1.
    Pratas E, Carvalho J, Domingues I, Fonseca J, Carvalho T, Sousa G, Veríssimo MT. Remitting Seronegative Symmetrical Synovitis with Pitting Oedema as the First Manifestation of an Adenocarcinoma of the Caecum. EJCRIM 2018;5 doi:10.12890/2018_000976.

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