Abstract
Neoplasms may present as rheumatic disorders. Some of these rheumatologic manifestations may be paraneoplastic and can clinically and serologically mimic rheumatoid arthritis (RA). We report the case of a patient who initially presented with an asymmetrical, rapid onset polyarthritis. It resembled atypical RA with positive rheumatoid factor and anticyclic citrullinated peptide (CCP) antibodies. A good response to steroid therapy was noted. A few weeks later, he was diagnosed with metastatic pancreatic cancer that resulted in his mortality. His clinical course suggested that his rheumatic symptoms were a paraneoplastic manifestation of his underlying malignancy. Anticyclic citrullinated peptide antibodies have not been previously described in cancer polyarthritis. Awareness of this atypical, seropositive RA-like syndrome may prompt clinicians to investigate for an underlying malignancy.
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