Connective Tissue Disease and Carcinoma of the Prostate Treated With Estrogens
IN reviewing the reports coexistence of malignancy and a collagen disease, dermatomyositis and a of form of arthritis clinically indistinguishable from rheumatoid arthritis are most frequently mentioned.1 The typical triad of hypertrophic (pulmonary) osteoarthropathy characterized by clubbing of the digits, periostitis, and synovitis occurring in middle life, is well recognized as heralding the onset of a serious visceral disorder, frequently a peripheral bronchogenic carcinoma.2
Various neoplasms may coexist with dermatomyositis or arthritis of the rheumatoid type; these include carcinoma arising from the lung, stomach, breast, ovary, colon, and pleura. Other types of neoplastic disorders, such as Hodgkin's disease, multiple myeloma, and reticuloendotheliosis, have been reported1 to be associated with one of the connective tissue diseases. It is well known that removal of the tumor often results in rapid and permanent improvement of the connective tissue disorder; however, if the primary lesion recurs, there may be reappearance of the connective tissue manifestations.
No report has been found in which carcinoma of the prostate was suspected of being related either to rheumatoid arthritis or to dermatomyositis. In this report, four cases are presented of carcinoma of the prostate gland and rheumatoid arthritis or dermatomyositis. The clinical course of these diseases suggests that a possible relationship exists between the neoplasm and the connective tissue disorders. Moreover, the favorable response to estrogen therapy in these patients is impressive, inasmuch as this form of treatment usually has no significant or lasting effect on rheumatoid arthritis,3 except possibly on mild nonprogressive arthritis in menopausal women.4
Case . . .