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Isolated knee monoarthritis heralding resectable non-small-cell lung cancer A paraneoplastic syndrome not previously described Cantini F; Niccoli L; Nannini C; Chindamo D; Bertoni M; Cassara E; Salvarani CAnn Rheum Dis 2007[Dec]; 66 (12): 1672-4OBJECTIVE: To describe isolated knee monoarthritis as a paraneoplastic syndrome heralding non-small cell lung cancer (NSCLC), and to discuss its clinical characteristics. METHODS: Clinical records of all consecutive, new outpatients with isolated knee monoarthritis observed from January 2000 to December 2005 were reviewed. A systematic review of Medline and Cochrane Library databases was performed to identify English-language articles related to rheumatological paraneoplastic syndromes associated with NSCLC. RESULTS: Over 6 years, 6654 new outpatients with different rheumatic disorders were observed. Of these, 296 (4.4%) presented with isolated monoarthritis of the knee. In five out of 296 patients (1.7%) this feature represented the initial manifestation of NSCLC. All five patients were middle-aged men, with a long history of heavy cigarette smoking, who had a non-erosive, isolated knee monoarthritis, with mild articular fluid collection of non-inflammatory type. NSCLC was resectable in all patients, and knee monoarthritis remitted with no relapse confirming its paraneoplastic nature. All five patients are in good condition after a median follow up of 41 months. The literature review revealed that paraneoplastic knee monoarthritis has not previously been reported. CONCLUSION: Knee monoarthritis may in some cases represent a paraneoplastic syndrome heralding NSCLC at an early stage.|*Knee Joint[MESH]|*Paraneoplastic Syndromes[MESH]|Aged[MESH]|Arthritis/*complications/pathology[MESH]|Carcinoma, Non-Small-Cell Lung/*complications/pathology[MESH]|Humans[MESH]|Information Storage and Retrieval[MESH]|Lung Neoplasms/*complications/pathology[MESH]|Male[MESH]|Middle Aged[MESH]|Neoplasm Staging[MESH]|Smoking[MESH]|Synovial Fluid[MESH] |
