A Case of Hypertrophic Pulmonary Osteoarthropathy in Both Upper and Lower Extremities: A Rare Involvement

Hypertrophic pulmonary osteoarthropathy (HPOA) is a paraneoplastic manifestation of gastric and, more frequently, lung carcinomas. It is characterized by extremity pain, clubbing, arthritis and periostitis of the long bones. Periostitis is the hallmark of HPOA and can be revealed with bone scintigraphy. Whole-body bone scintigraphy (WBBS) is very sensitive during the active lesion period and WBBS findings usually precede that of plain radiography. WBBS can also show improvement in the first 6 months following treatment, thus making it an important technique in the management and follow-up of these patients. While HPOA findings are usually seen in the lower extremities, involvement of both upper and lower extremities is a rare condition. In this case report, it is aimed to present findings of a 67-year-old male patient with lung cancer and complaint of extremity pain. We report on this patient to draw attention to HPOA of both upper and lower extremities.

Üst ve Alt Ekstremitede Hipertrofik Pulmoner Osteoartropati Olgusu: Nadir Bir Görünüm

Hipertrofik pulmoner osteoartopati (HPOA), mide ve özellikle akciğer kanserlerinde görülebilen bir paraneoplastik sendromdur. Çomak parmak, artrit, ekstremite ağrısı ve uzun kemiklerde periostit ile karakterizedir. Periostit HPOA’nın ayırıcı bulgularındandır ve sintigrafi ile gösterilebilir. Sintigrafik bulgular çoğunlukla radyolojik bulgulardan önce ortaya çıkar. Tüm vücut kemik sintigrafisi (TVKS) aktif lezyon döneminde oldukça duyarlıdır. TVKS ile tedavi sonrası ilk 6 ayda bulgularda gerileme gösterilebilir. Dolayısıyla TVKS, bu hastaların tanı ve takibinde önemli bir yer tutar. HPOA bulguları çoğunlukla alt ekstremitede görülür; hem üst hem alt ekstremite tutulumu nadir görülen bir durumdur. Bu olgu takdimi, ekstremite ağrısı ile başvuran akciğer kanseri hastalarında, hem alt hem üst ekstremitede nadiren görülen HPOA tablosuna dikkat çekmek amacıyla sunulmaktadır.

Kaynakça

Ntaios G, Adamidou A, Karamitsos D. Hypertrophic pulmonary osteoarthropathy secondary to bronchial adenocarcinoma and coexisting pulmonary tuberculosis: a case report. Cases J 2008;1:221.

Cruz C, Rocha M, Andrade D, Guimarães F, Silva V, Souza S, Moura CA, Moura CG. Hypertrophic pulmonary osteoarthropathy with positive antinuclear antibodies: case report. Case Rep Oncol 2012;5:308-312.

Rhee SM, Park KJ, Ha YC. Hypertrophic Osteoarthropathy in Patient with Crohn’s Disease: A Case Report. J Bone Metab 2014;21:151154.

Qian X, Qin J. Hypertrophic pulmonary osteoarthropathy with primary lung cancer Oncol Lett 2014;7:2079-2082.

Kaynak Göster

Molecular Imaging and Radionuclide Therapy
  • ISSN: 2146-1414
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 1992

1.3b463

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