Palmar fasciitis and polyarthritis associated with gastric carcinoma: Complete resolution after total gastrectomy

Palmar fasciitis and polyarthritis (PFA) is a rare paraneoplastic rheumatic syndrome characterized by flexion contractures of both hands and thickenin g of palmar fascia. Several reports have suggested that this syndrome is a tumor-associated autoimmune disorder. We report a 44-year-old Japanese man who presented with flexion contractures of both hands associated with thick ening of palmar fascia and polyarthritis. These clinical pictures were sugg estive of PFA associated with occult neoplasm. Upper gastrointestinal endos copic examination revealed advanced gastric cancer. Resection of the cancer resulted in a gradual resolution of palmar fasciitis and polyarthritis. Th is clinical course suggests an underlying tumor-related immunologic process in this syndrome.