A case of treatment-refractory paraneoplastic polymyalgia rheumatica that improved after tumor resection
Polymyalgia rheumatica and papillary thyroid carcinoma
DOI:
https://doi.org/10.17161/rrnmf.v5i3.21364Keywords:
Polymyalgia Rheumatica, Papillary thyroid carcinoma, paraneoplastic syndrome, proximal weakness, myalgias, case reportAbstract
We present a case of a 53-year-old man whose clinical history, examination, and laboratory markers were deemed consistent with the diagnosis of polymyalgia rheumatica (PMR). These symptoms were initially relieved by oral steroids but unexpectedly returned with repeated attempts to taper the steroid dose slowly over time. Among his extensive evaluations for these symptoms, an MRI of the cervical spine was performed and demonstrated an ‘incidental’ thyroid mass. This was eventually diagnosed as papillary thyroid carcinoma and a total thyroidectomy was performed 6 months after his PMR symptom onset. The patient’s refractory PMR symptoms resolved shortly thereafter, and he was successfully weaned from oral steroids. This remission following tumor resection posed an interesting question of a paraneoplastic process, which will be explored here.
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Copyright (c) 2024 Loran Grant ENS MC USN, Alex Kim MD CPT MC USA, Michael B. Beeler MD LCDR MC USN, Johnathan S. Bresner MD
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