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07 April 2019 : Case report  USA

A Case of Polymyalgia Rheumatica Following Robotic-Assisted Radical Prostatectomy for High-Grade Prostate Cancer

Rare coexistence of disease or pathology

Madeleine S. Deming1ABEF*

DOI: 10.12659/AJCR.914152

Am J Case Rep 2019; 20:474-477

Abstract

BACKGROUND: Polymyalgia rheumatica (PMR) is a common rheumatic disease in patients over the age of 50 years. Underlying triggers for PMR are not well understood, but there have been reports of cases presenting prior to the diagnosis of prostate cancer, with one case of PMR presenting following prostatectomy. This report is of a case of PMR that presented following robotic-assisted radical prostatectomy for high-grade prostate cancer and includes a discussion of the possible associations.

CASE REPORT: A 61-year-old man underwent a robotic-assisted radical prostatectomy for high-grade prostate adenocarcinoma, Gleason grade 4+4=8. The surgical procedure and the patient’s postoperative recovery were uneventful, and he was discharged from hospital on the day after surgery. Approximately two weeks later, he developed bilateral symptoms of pain in the groin, thigh, and shoulder girdle. His erythrocyte sedimentation rate (ESR) (30 mm/h) and C-reactive protein (CRP) (16.2 mg/L) levels were raised. A diagnosis of PMR was made and treatment with tapered dosing of methylprednisolone resulted in a 90% improvement in symptoms after four weeks.

CONCLUSIONS: A case of PMR following robotic-assisted prostatectomy for high-grade prostate carcinoma is presented. To the author’s knowledge, this is only the second report of PMR following prostatectomy and the only reported case following robotic-assisted radical prostatectomy.

Keywords: Polymyalgia Rheumatica, Prostatectomy, Prostatic Neoplasms, Robotics, Blood Sedimentation, C-Reactive Protein, Robotic Surgical Procedures

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923