In my experience the best predictor of paraneoplastic syndrome in PR is the lack of response to corticosteroids.

Dear Ciro,

I suggest to read this article. 

http://www.amjcaserep.com/abstract/index/idArt/895717 

Thanks , dear Amir.

I already knew your case report. I have visited some years ago an elderly man in which a PMR picture with SR3PE onset allowed me to diagnosis of prostatic cancer in absence of PSA elevation. I have no published this case, even if interesting because the relatives were not agree.   

Dear Ciro,

I sholud say that the interesing part of this case report is peresenting rs3pe twice with two different diagnosis.

Regards. 

Dear Ciro,

I think we should always take into account the possibility of cancer in patients with PMR and especially with the  RS3PE syndrome, lack of response to corticosteroids in general can undermine our diagnosis it's like a bell in our mind!

Especially the co-existence of general symptoms like weight loss, fever, deepening anemia is an obvious signal to look for a cancer, of course, also age - but even so the diagnosis is established in late period of life which  increases the risk of many cancers

best regards

My experience is that the possibility that PMR can be a paraneoplastic syndrome is  overestimated . Over the past 10 years our Group met only 4 times this possibilty (among > 200 cases)  . In 3 of these (prostatic cancer, multiple myeloma, ovarian cancer) PMR had RS3PE as a  manifestation.   

The role of VEGF in the pathogenesis of RS3PE syndrome (and not in the pathogenesis of PMR) would speculate that the presence of RS3PE during PMR is not only a manifestation of the same PMR.

Is PMR + RS3PE a clinical entity in its own right ?