Abstract
A 68-year-old man complaining of pain of the whole body was diagnosed as having polymyalgia rheumatica at the department of orthopedics and steroid therapy was started. After a temporary remission, general pain recurred. Close exploration revealed a tumor of the left lower lobe of the lung and left lower lobectomy was performed. The histopathological diagnosis was carcinosarcoma involving squamous cell carcinoma and angiosarcoma. His pain and inflammatory reaction dramatically improved after the operation, however, 9 months later, general pain became worse again and inflammatory reaction was also increased. As a result of close exploration, a solitary metastatic lesion of pulmonary carcinosarcoma was identified at the duodenum. Pancreaticoduodenectomy was thus performed. His pain and inflammatory reaction subsided after the operation, and no recurrence has occurred up to now.
This case is of lung carcinosarcoma involving rare angiosarcoma component and its recurrence to a rare site of the duodenum was resected. Clinically pain of the whole body was noted in this patient, and disappearance of the tumor and pain was well correlated with increase and decrease in CRP and IL-6 levels. We rarely encounter patients with symptoms which are similar to those of polymyalgia rheumatica due to malignant neoplasm, but no patients presenting such symptoms due to carcinosarcoma like in this case have been reported so far and this is the first reported case.
