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Hand Arthritis Tips Doctors Off to Ovarian Cancer

Doctors at the Mayo Clinic in Jacksonville, Florida, report four cases of arthritis from ovarian cancer. In each case the women had their first symptoms in the hands. Swelling, stiffness, and pain were reported. Then the palms became red, and bumps or nodules formed. One woman also had carpal tunnel syndrome.

Diagnosis was delayed because the standard lab values were all normal. X-rays and MRIs were typical for arthritis. It wasn't until the tumor was large enough to be found that a correct diagnosis was made and proper treatment started. Most cases of ovarian cancer were found at an average of nine months. In one case the patient had inflammatory muscle pain for five years before having hand symptoms.

By the time an accurate diagnosis was made, the women had joint contractures of the hands. This means the joints could no longer straighten and the women couldn't open their hands fully. Hand pain improved with treatment of the cancer. Joint motion didn't change for three of the four women. In one case, the cancer spread to the lungs. Despite treatment, she died.

Ovarian cancer is the fifth leading cause of cancer deaths for women in the United States. Reliable screening tests haven't been found yet. The authors suggest that any women with sudden symptoms of hand arthritis or changes in the palms should be checked for cancer.

Edgar A. Martorell, MD, et al. Palmar Fasciitis and Arthritis Syndrome Associated with Metastatic Ovarian Carcinoma: A Report of Four Cases. In The Journal of Hand Surgery. July 2004. Vol. 29A. No. 4. Pp. 654-660.


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