Isolated knee monoarthritis heralding resectable non-small-cell lung cancer. A paraneoplastic syndrome not previously described. Issue 12 (3rd September 2007)

• Record Type: Journal Article
• Authors: Cantini, Fabrizio; Niccoli, Laura; Nannini, Carlotta; Chindamo, Daniela; Bertoni, Michele; Cassarà, Emanuele; Salvarani, Carlo
• Is Part Of: Annals of the rheumatic diseases. Volume 66:Issue 12(2007)
• Page Start: 1672
• Page End: 1674
• Publication Date: 2007-09-03
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/ard.2007.075333
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objective: To describe isolated knee monoarthritis as a paraneoplastic syndrome heralding non-small cell lung cancer (NSCLC), and to discuss its clinical characteristics. Methods: Clinical records of all consecutive, new outpatients with isolated knee monoarthritis observed from January 2000 to December 2005 were reviewed. A systematic review of Medline and Cochrane Library databases was performed to identify English-language articles related to rheumatological paraneoplastic syndromes associated with NSCLC. Results: Over 6 years, 6654 new outpatients with different rheumatic disorders were observed. Of these, 296 (4.4%) presented with isolated monoarthritis of the knee. In five out of 296 patients (1.7%) this feature represented the initial manifestation of NSCLC. All five patients were middle-aged men, with a long history of heavy cigarette smoking, who had a non-erosive, isolated knee monoarthritis, with mild articular fluid collection of non-inflammatory type. NSCLC was resectable in all patients, and knee monoarthritis remitted with no relapse confirming its paraneoplastic nature. All five patients are in good condition after a median follow up of 41 months. The literature review revealed that paraneoplastic knee monoarthritis has not previously been reported. Conclusion: Knee monoarthritis may in some cases represent a paraneoplastic syndrome heralding NSCLC at an early stage.