title: Migrating Polyarthritis as a Feature of Occult Malignancy: 2 Case Reports and a Review of the Literature.
abstract: Malignant disease may be associated with a wide variety of musculoskeletal syndromes. Rarely the musculoskeletal system can be indirectly affected by paraneoplastic phenomena, such as carcinomatous polyarthritis (CP). The differential diagnosis for CP is broad and is often a diagnosis of exclusion. CP often presents similarly to other forms of inflammatory arthritis, and a detailed history and physical examination can often distinguish CP from other more common causes of polyarticular arthritis. However serological tests such as rheumatoid factor (RF) and anti-citrullinated peptide (anti-CCP) antibody positivity, while rare, can be misleading. Clinical awareness and suspicion are paramount in achieving an accurate diagnosis and early detection of an occult neoplasm is critical for prompt management and therapy. We report two cases presenting with this unique clinical phenotype associated with paraneoplastic polyarthropathy and review the literature.
authors.affiliation: St. Vincent's University Hospital, Dublin, Ireland.
authors.forename: Geoffrey Alan
authors.initials: GA
authors.lastname: Watson
authors.affiliation: St. Vincent's University Hospital, Dublin, Ireland.
authors.forename: Lorraine
authors.initials: L
authors.lastname: O'Neill
authors.affiliation: St. Vincent's University Hospital, Dublin, Ireland.
authors.forename: Ruth
authors.initials: R
authors.lastname: Law
authors.affiliation: Mater Misericordiae University Hospital, Dublin, Ireland.
authors.forename: Geraldine
authors.initials: G
authors.lastname: McCarthy
authors.affiliation: St. Vincent's University Hospital, Dublin, Ireland.
authors.forename: Douglas
authors.initials: D
authors.lastname: Veale