CANCER-ASSOCIATED FASCIITIS PANNICULITIS

Background. Eosinophilic fasciitis and the related fasciitis panniculi tis syndrome (FPS) are the clinical and morphologic expression of a va riety of disorders, of which chronic inflammation and fibrous thickeni ng of the subcutaneous septa, fascia, and perimysium are common. FPS i n patients with cancer has been reported sporadically. Methods. In the course of our studies of FPS we have encountered three patients who h ad an associated neoplasia. Nine reports of patients have been taken f rom the literature. The clinical and histologic data of FPS in the 12 patients were analyzed in the search of distinctive features from FPS in patients with no evidence of malignancy. Results. Among patients wi th cancer-associated FPS there was a female predominance (8 patients), predilection for hematolymphatic malignancies (9 patients), precedenc e of the FPS to cancer diagnosis (10 patients) by a median lag time of 1 year, and unresponsiveness to prednisone therapy in most patients ( 7 of 8 patients). Conclusions. Cancer-associated FPS has several chara cteristics of a paraneoplastic syndrome: it occurs at a distance from the tumor, certain types of tumors are overrepresented among patients with FPS, it evolves in concert with the neoplasia, and it sometimes r emits after successful cancer surgery. In contrast to idiopathic FPS, cancer-associated FPS shows a female predominance, and it usually fail s to respond to corticotherapy.