Proximal musculoskeletal symptoms mimicking the clinical picture of polymyalgia rheumatica may herald the onset of solid malignancies. We report on three patients presenting with polymyalgia-like symptoms, who had renal cell carcinoma. The review of the literature and our cases suggest that the absence of prolonged morning stiffness, the atypical clinical findings, the inefficacy of corticosteroids, and the absence of shoulder sonographic pathologic findings may help to facilitate the proper diagnosis.