Abstract
Rheumatoid arthritis is a common autoimmune disease. Malignancy is a serious complication of rheumatoid arthritis and its treatment. In this article, we discuss a 61-year-old woman who is a known case of Rheumatoid arthritis and secondary Sjögren's syndrome treated with disease-modifying anti-rheumatoid drugs and multiple lines of biological therapies. She was found to have recto-sigmoid cancer, disseminated tuberculosis infection, and acute lymphoid leukemia at different intervals of treatment. Therefore, it is advisable to initiate appropriate screening programs that target high-risk people for malignancy.