Concurrent temporal (giant cell) arteritis and malignancy: report of 20 patients with review of the literature.
OBJECTIVE
To determine the frequency of occurrence of malignancy concurrently with temporal arteritis (TA), as well as features and outcome of the vasculitis in such cases.


METHODS
In a series of 271 consecutive patients with TA (219 biopsy-proven), we retrospectively analyzed the frequency and type of malignancy concurrent with vasculitis (less than 1 year before or after), as well as the main features and outcome of TA in this setting. We also surveyed all cases published in the French-British literature.


RESULTS
We observed 20 patients with TA and concurrent malignancy and reviewed 27 similar published reports. GCA was documented pathologically in 86% of the cases. The time between diagnosis of TA and that of malignancy averaged 3.5 months (synchronous diagnoses in 27 patients). Various locations of cancers were found, particularly the gastrointestinal tract (9 cases); blood malignancies accounted for 45% of cases (lymphoid disorder in 9, myelodysplastic syndrome in 11, chronic myelogenous leukemia in 1). In our patients, logistic regression analysis failed to demonstrate differences between those with and without malignancy, except for a higher frequency of rheumatic involvement in the former group (60% vs 30%; p = 0.01). The initial response to steroid treatment was good in 92% of 40 assessable patients, and the vasculitis course mirrored that of malignancy in only 2 patients. Regarding the outcome of TA, no differences were observed in our patients with and without malignancy.


CONCLUSIONS
Concurrent malignancy in TA is not a rare finding, being observed in up to 7.4% of the cases. Solid malignancies and hematological disorders, especially myelodysplastic syndromes, may represent precipitating factors for development of TA, which infrequently run a paraneoplastic course. Patients with and without malignancy seem almost indistinguishable regarding features and outcome of TA. Physicians who care for patients with TA should be mindful of this potential association, even in typical cases.
Liozon
Eric
E
Department of Internal Medicine, University Hospital, Limoges, France. eric.liozon@unilim.fr
Loustaud
Véronique
V
Fauchais
Anne-Laure
AL
Soria
Pascale
P
Ly
Kim
K
Ouattara
Baly
B
Rhaiem
Kaïef
K
Nadalon
Sylvie
S
Vidal
Elisabeth
E
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D015897:Comorbidity; D005260:Female; D005602:France / Q000453:epidemiology; D013700:Giant Cell Arteritis / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies
D005938:Glucocorticoids