Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome is a definite subset of the seronegative symmetrical polyarthritis of the aged, characterized by dramatic pitting edema of the hands, male predominance, old age and exquisite response to corticosteroids. RS3PE syndrome is a rare but well-defined syndrome known to be associated with solid tumors and haematologic malignancies. Recent research has shown that it is not a specific entity but rather a syndrome that can represent the inaugural form of various types of rheumatic disease and neoplastic conditions of the elderly. A thorough examination in elderly patients with RS3PE syndrome, and heightened suspicion of potential underlying malignant disease is necessary.