Remitting Seronegative Symmetrical Synovitis with Pitting Edema (rs3pe) Syndrome and Malignancy

first Remmitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE) syndrome which is characterized by symmetrical distal synovitis, tenosynovitis of the mucous sheaths of the flexor and extensor tendons of the hands, pitting edema of the hands and/or feet, seronegativity for the Rheumatoid Factor (RF) and benign prognosis, mainly affecting the elderly and the males, exquisite response to corticosteroids, and long term remission after withdrawal. There is no joint erosion. Magnetic resonance imaging studies have demonstrated severe extensor tenosynovitis believed to be the principal lesion responsible for the edema of the subcutaneous and peritendineous soft tissues of the dorsum (2). Although the RS3PE syndrome appeared as a well characterized entity, in the recent research has shown that it is not a specific entity but rather a syndrome that can represent the inaugural form of various types of rheumatic disease and neoplastic conditions of the elderly (3). RS3PE syndrome has a good prognosis. Nevertheless, there have been reports of apparently classic RS3PE syndromes that were complicated by other rheumatic disease such as polymyalgia rheumatica and temporal arteritis, polyarteritis nodosa or other vasculitides, late onset rheumatoid arthritis, ankylosing spondylitis, acute sarcoidosis and spondyloarthropaties. RS3PE syndrome REMITTING SERONEGATIVE SYMMETRICAL SYNOVITIS WITH PITTING EDEMA (RS3PE) SYNDROME AND MALIGNANCY