Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) almost exclusively affects elderly men and can occur independently or may be associated with a vast array of clinical conditions including underlying malignancy. Patients present with a polyarthritis similar to rheumatoid arthritis. We describe a case of an elderly man presenting with RS3PE who developed acute myeloid leukemia. It is important for clinicians to be aware of this possibility and initiate appropriate investigations, particularly if systemic symptoms are prominent, to detect an occult malignancy at a potentially earlier stage
