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Malignancy and rheumatic disorders

Ami A Shah, MD, MHS
Laura Cappelli, MD, MHS
Section Editor
Peter H Schur, MD
Deputy Editor
Paul L Romain, MD


There are several different bidirectional connections between rheumatic diseases and cancer, reflecting the complexity of disease pathogenesis and treatment. Certain rheumatologic diseases are associated with an increased risk of malignancy. On the other hand, some malignancies have rheumatologic symptoms and may present with joint, muscle, and soft tissue manifestations [1,2].

The reasons for the increased risk of malignancy are still unclear but likely involve both chronic inflammation triggering malignancy and autoimmunity arising as a byproduct of naturally occurring anti-tumor immune responses. Rheumatic diseases in this group include dermatomyositis, polymyositis, rheumatoid arthritis (RA), systemic lupus erythematosus, Sjögren's syndrome, and systemic sclerosis [1,3].

The malignancies that have the most frequent musculoskeletal findings are leukemias and lymphomas, but paraneoplastic syndromes also occur with solid tumors. Additionally, therapies for malignancy can cause rheumatic disease syndromes as demonstrated with immune checkpoint inhibitors [4]. Finally, treatments for rheumatic diseases may increase the risk for malignancy.

This topic will provide an overview of the following:

Specific rheumatic diseases and risk of malignancies

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Literature review current through: Nov 2017. | This topic last updated: Jun 29, 2017.
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