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November 10, 1997

Atypical Polymyalgia Rheumatica as a Presentation of Metastatic Cancer

Author Affiliations

Haifa, Israel

Arch Intern Med. 1997;157(20):2381. doi:10.1001/archinte.1997.00440410115014

In an ARCHIVES article, Brooks and McGee1 reflected on diagnostic dilemmas in polymyalgia rheumatica (PMR). Atypical presenting features pose problems in the diagnosis of PMR, especially since there are a wide variety of diseases that can mimic PMR. A PMR-like syndrome is occasionally the first clinical expression of disseminated cancer. This presentation has been described in the literature,2 and additional cases are reported herein.

Patients admitted to the medical ward of a general hospital during an 11-year period were surveyed for the presence of a PMR syndrome in the context of cancer. In all cases, PMR was observed in patients with metastases to bones and joints; none of the patients had the paraneoplastic type of PMR. There were 5 men and 2 women, ranging in age from 37 to 84 years (Table). The onset of PMR preceded the diagnosis of cancer by 1 to 13 months. Systemic symptoms

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