Adenocarcinoma Lung in Chronic Rheumatoid Arthritis

Abstract We present a case of chronic rheumatoid arthritis (RA) in a chronic smoker who developed metastatic adenocarcinoma of the lung. Since this patient was on long-term methotrexate as a disease-modifying anti-rheumatic drug and had positive RA factor and anti-centromere antibody, which were predisposing factors for induction of lung cancer. His clinical course was complicated with RA-associated interstitial lung fibrosis which was yet another contributory factor for lung cancer. There was a poor response to chemotherapy. As the disease progressed, his performance status declined rendering him unfit for combination chemotherapy and died. Though RA is a chronic and most common rheumatological condition in clinical practice, we come across non-malignant complications involving the heart, lungs, brain, skin, gastrointestinal tracts, and bone but malignant complications are relatively few. There are very few cases of cancer in RA in Indian literature.