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The Paraneoplastic Meaning of R3SPE (Remitting Seronegative Simmetrical Synovitis with Pitting Edema) Syndrome

Ciro Manzo

Introduction: Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is an uncommon elderly-onset rheumatic disease characterized by tenosynovitis of both flexor and extensors tendons at the wrist and at the feet. Cancer has been reported in association with this syndrome since 1985.

Materials and method: We perform a systematic electronic search of Medline and PubMed for evaluation of relationship between cancer and RS3PE and present in this review the more significant data.

Results: The paraneoplastic weight of RS3PE syndrome is greater than other clinical pictures. In our experience, when RS3PE is associated with polymyalgia rheumatic (PMR), the probability of a paraneoplastic picture is very high (28.5% in our PMR+RS3PE cohort had a cancer diagnosed in an observation time of 24 months vs. 2.04% in cohort of PMR without RS3PE).

Conclusion: The possibility that RS3PE can be considered a paraneoplastic phenomenon or a generic risk factor for cancer is still debated. The repercussions of these evaluations on health policies are easily understandable. More data must be available.