Acute lymphoblastic leukemia initially presenting with polymyalgia rheumatica

Polymyalgia rheumatica (PMR) is a clinical syndrome of unknown etiology characterized by aching and stiffness in the shoulder girdle, pelvic girdle, and neck that occurs in people over the age of 50 years. New-onset proximal muscle pain and stiffness in subjects older than 50 are the most common symptoms of PMR, but polymyalgic pain can also be present in patients with malignant neoplasms. The musculoskeletal system may be involved in malignancy either directly or indirectly, particularly in cases involving hematological malignancies. Only a few cases of cancer-associated PMR have been reported worldwide, and this is the first in Korea. We report the case of a 58-year-old man diagnosed with PMR associated with acute lymphoblastic leukemia. (Korean J Med 76:S234-S237, 2009)