A variety of rheumatological diseases are associated with malignancies; among these polymyositis-dermatomyositis, carcinomatous polyarthritis, and palmar fasciitis are the most common.1 ,2 Other associated diseases include reflex algoneurodystrophy—that is, shoulder-hand syndrome or Sudeck's atrophy. In 1985 a syndrome characterised by tenosynovitis of the sheaths of the tendons of hands, symmetrical distal synovitis, pitting oedema over the hand dorsum and the feet (less commonly over the pretibial region), and rheumatoid factor seronegativity was described.3 This syndrome, with generally benign prognosis, was reported during the 1990s, but only in 1994 were clinical criteria for diagnosis proposed.4 In a few cases this syndrome was associated with malignancies: one with endometrial adenocarcinoma, two with gastric carcinoma, four with prostatic carcinoma, and one with colic carcinoma.5-7 We report the case of a woman affected by remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) and concurrent ovarian carcinoma.