Abstract
Polymyalgia rheumatica （PMR） is a chronic inflammatory disease of unknown cause associated with malignant tumors. We report a case of PMR due to pain in the shoulder joint and chronic inflammatory reaction after surgery for oral floor cancer. The patient was an 81-year-old woman who visited our department with a chief complaint of ulceration of the oral floor. With the diagnosis of SCC cT4aN0M0 of oral floor cancer, resection of the oral malignant tumor and reconstruction with a scapular flap were performed. After surgery, inflammatory responses with frequent pyrexia and persistent high C-reactive protein （CRP） were noted. There was no obvious site of infection. On the 69th day after the operation, the white blood cell count was 7,990/μl and CRP was 20.724mg/dl, and strong shoulder joint pain was noted. Therefore, the patient was examined in consideration of the possibility of autoimmune disease. The erythrocyte sedimentation rate increased to 103mm/h, and the autoimmune antibody was negative, satisfying the diagnostic criteria for PMR. Prednisolone （PSL） 15mg/day was started, and the pain improved remarkably. Currently, at PSL 8mg/day, the progress is uneventful without relapse. PMR is difficult to diagnose because its symptoms are similar to those of perioperative invasion and aspiration pneumonia, but the symptoms can be significantly improved by early diagnosis and treatment; such possibility should be kept in mind.
