Polymyalgia Rheumatica and Asthma Attack Presenting as the Initial Symptoms of Gastric Cancer

Abstract

Gastric cancer has varied clinical manifestations, sometimes the symptoms seem to be nothing related to the gastrointestinal diseases, which makes it difficult for doctors to come to the correct diagnosis of gastric cancer in those patients. We report a case of polymyalgia Rheumatica and intermittent asthma attack presenting as the initial symptoms of gastric cancer. A 51-year-old female visited our hospital with complaint of multi-point pain of her body for three months, accompanied with asthma-like attack and abdominal mass for 2 weeks. All the results of rheumatoid factor and antinuclear factor were negative. She didn't get any benefit from the treatment of prednisone, MTX and folic acid. Then upper gastrointestinal(GI) endoscopy demonstrated a gastric cancer. The patient underwent radical gastrectomy with D2 lymph node dissection and complex of intestinal adhesion release, her polymyalgia Rheumatica and asthma-like attack were relieved 1 week later, she gained weight and received chemotherapy. Followed up 6 years by for now, she was found going well without any evidence of recurrence of cancer or any episode of flareup of polymyalgia Rheumatica or asthma. This indicates that when doctors met patients whose clinical manifestations were shown as refractory ones, the underlying cancer should be under consideration.