Atypical Polymyalgia Rheumatica as a Presentation of Metastatic Cancer

In anARCHIVESarticle, Brooks and McGee 1 reflected on diagnostic dilemmas in polymyalgia rheumatica (PMR). Atypical presenting features pose problems in the diagnosis of PMR, especially since there are a wide variety of diseases that can mimic PMR. A PMR-like syndrome is occasionally the first clinical expression of disseminated cancer. This presentation has been described in the literature, 2 and additional cases are reported herein. Patients admitted to the medical ward of a general hospital during an 11-year period were surveyed for the presence of a PMR syndrome in the context of cancer. In all cases, PMR was observed in patients with metastases to bones and joints; none of the patients had the paraneoplastic type of PMR. There were 5 men and 2 women, ranging in age from 37 to 84 years ( Table ). The onset of PMR preceded the diagnosis of cancer by 1 to 13 months. Systemic symptoms