Paraneoplastic polyarthritis as the first manifestation of lingual carcinoma

Abstract

Paraneoplastic polyarthritis is an inflammatory arthritis, is usually seronegative, and has a temporal andpathophysiological relationship with an underlying malignancy. Although head and neck tumors maybe a cause of paraneoplastic polyarthritis, its association with tongue carcinoma has not been previous-ly reported. We present the case of a 69-year-old man who was a former smoker and presented withpolyarthritis since 2 months in the wrists, proximal interphalangeal joints, knees, and elbows, with in-creased levels of acute-phase reactants; negativity for rheumatoid factor, anticitrullinated cyclic peptideantibody, and antinuclear antibody; and negative results for crystals and microorganisms in the synovialfluid. Cervical computed tomography and posterior rhinoscopy were performed, which detected anasymptomatic lesion on the base of the tongue, whose biopsy was compatible with nonkeratinizingsquamous cell carcinoma. Polyarthritis did not respond to glucocorticoids at medium doses (oral pred-nisone 20 mg/day) but progressively resolved after the initiation of antineoplastic therapy.