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July 22, 1996

Resolution of a Soft-Tissue Sarcoma in a Patient With Rheumatoid Arthritis After Discontinuation of Azathioprine Therapy

Author Affiliations

From the Departments of Rheumatology (Dr Csuka) and Pathology (Dr Hanson), Medical College of Wisconsin, Milwaukee.

Arch Intern Med. 1996;156(14):1573-1576. doi:10.1001/archinte.1996.00440130123013

An 85-year-old woman with rheumatoid arthritis that was treated with azathioprine presented with a posterior thoracic soft-tissue mass. A computed tomographic scan demonstrated a large mass in the chest wall that extended into the pleural space and several pulmonary nodules that were consistent with metastatic disease. A fine-needle biopsy was performed, and a morphologic diagnosis of sarcoma was made. As the patient was relatively asymptomatic and the lesion was inaccessible to a surgical procedure, no therapy was recommended. Therapy with azathioprine was discontinued. One year later, the mass had resolved. To our knowledge, this is the first reported case of a soft-tissue sarcoma complicating azathioprine treatment of rheumatoid arthritis.

Arch Intern Med. 1996;156:1573-1576