2018 Volume 58 Issue 2 Pages 105-110
Background. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome is a paraneoplastic syndrome that causes symmetrical synovitis with pitting edema at the periphery of the arms and legs. Although 10-40% of cases of RS3PE syndrome are associated with malignant tumors, few lung cancer-associated cases have been reported. Case. At his annual health check-up, a 67-year-old man was evaluated for an abnormal chest X-ray shadow. Computed tomography revealed a lung nodule of 0.9 cm (consolidation size: 0.3 cm) in the right S2b. After a one-year observation period, the nodule was found to have grown to 1.1 cm (consolidation size: 0.7 cm) in size; thus, we decided to perform surgical resection. In the two months before surgery, the patient had suffered from pitting edema of the bilateral legs. A detailed examination was performed; however, the cause of edema could not be identified. We performed right S2 segmentectomy with hilar lymph node dissection and diagnosed minimally invasive adenocarcinoma (pT1miN0M0-stage IA1). His edema rapidly improved, and a follow-up examination at one year after surgery revealed no signs of recurrence of lung cancer or edema. We suspected that the RS3PE syndrome was associated with the patient's lung cancer. Conclusion. When evaluating lung cancer patients who develop symmetrical synovitis with pitting edema, we should consider the possibility of of RS3PE syndrome.
