title: [Factitious diseases in oncology].
abstract: Factitious diseases and pathomimias and particularly Munchausen's syndrome, due to their rarity, are poorly diagnosed by medical teams working in oncology. Consequences can be serious and result in unadapted surgery or non justified implementation of chemotherapy and radiotherapy regimens. These patients simulate diseases in order to attract medical attention. They might become belligerent and are likely to promptly discharge themselves from hospital if they do not get the desired attention or are unmasked. With two following case reports and literature review, we would like to alert clinicians about difficulties encountered in diagnosis and management of factitious disorders. When faced with this diagnosis, the patient will tend to deny reality and break contact with the medical team who exposed him. Medical peregrinating behavior surrounded by conflicts with medical team, past psychiatric illness, history of working in the medical and paramedical field and social isolation can guide the diagnosis. Somaticians and especially surgeons working in the oncologic field must remain vigilant about this diagnosis and collaborate with either the psycho-oncologic team or the consultation-liaison psychiatric team. Some recommendations for medical professionals how to cope with these patients will be suggested.
authors.affiliation: Centre Oscar-Lambret, équipe de psycho-oncologie, 3, rue Frédéric-Combemale, BP 307, 59020 Lille cedex, France. Electronic address: m-reich@o-lambret.fr.
authors.forename: Michel
authors.initials: M
authors.lastname: Reich
authors.affiliation: Centre hospitalier de Roubaix, service d'urgence médicale, 11, boulevard Lacordaire, 59100 Roubaix, France.
authors.forename: Amélie
authors.initials: A
authors.lastname: Clermont
authors.affiliation: Centre Oscar-Lambret, département d'uro-digestif, 3, rue Frédéric-Combemale, BP 307, 59020 Lille cedex, France.
authors.forename: Éric
authors.initials: É
authors.lastname: Amela
authors.affiliation: Centre Oscar-Lambret, département de cancérologie générale, 3, rue Frédéric-Combemale, BP 307, 59020 Lille cedex, France.
authors.forename: Nuria
authors.initials: N
authors.lastname: Kotecki
mesh_terms: D001943:Breast Neoplasms / Q000523:psychology; D003291:Conversion Disorder / Q000523:psychology; D003937:Diagnosis, Differential; D005162:Factitious Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D049671:History, 18th Century; D049673:History, 20th Century; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009110:Munchausen Syndrome / Q000175:diagnosis / Q000266:history / Q000523:psychology; D015995:Prevalence; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology; D013736:Testicular Neoplasms / Q000523:psychology
keywords: Cancer; Factitious disorders; Munchausen's syndrome; Pathologies factices; Syndrome de Münchhausen