1/52. Palmar fasciitis and polyarthritis associated with gastric carcinoma: complete resolution after total gastrectomy.Palmar fasciitis and polyarthritis (PFA) is a rare paraneoplastic rheumatic syndrome characterized by flexion contractures of both hands and thickening of palmar fascia. Several reports have suggested that this syndrome is a tumor-associated autoimmune disorder. We report a 44-year-old Japanese man who presented with flexion contractures of both hands associated with thickening of palmar fascia and polyarthritis. These clinical pictures were suggestive of PFA associated with occult neoplasm. Upper gastrointestinal endoscopic examination revealed advanced gastric cancer. Resection of the cancer resulted in a gradual resolution of palmar fasciitis and polyarthritis. This clinical course suggests an underlying tumor-related immunologic process in this syndrome.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/52. Hypertrophic osteoarthropathy in a child with nasopharyngeal carcinoma.We report a 13-year-old boy with nasopharyngeal carcinoma, skull metastases and hypertrophic osteoarthropathy. Although the metastases and the primary tumour responded well to chemotherapy, hypertrophic osteoarthropathy persisted during follow-up.- - - - - - - - - - ranking = 1.25keywords = carcinoma (Clic here for more details about this article) |
3/52. Reactivation of primary hypertrophic osteoarthropathy by bronchogenic carcinoma.This paper reports 2 cases of primary hypertrophic osteoarthopathy (PHO) which evolved into secondary hypertrophic osteoarthopathy (SHO) under the influence of bronchogenic carcinoma. The patients had a clinical picture of primary hypertrophic osteoarthropathy but without any signs of disease activity until in the last several months when a malignant bronchopulmonary condition developed. This activated all the symptoms: joint swelling; enlarged fingers and distal forearms and legs; moist palms and soles; unpleasant odour of perspiration; and deeper folds of the forehead and nasolabial furrow. A bone scan showed increased accumulation of the radioisotope in specific regions of the skeleton. To our knowledge, no similar cases have been described in the literature.- - - - - - - - - - ranking = 1.25keywords = carcinoma (Clic here for more details about this article) |
4/52. Hypertrophic osteoarthropathy: an unusual manifestation in nasopharyngeal cancer.A patient with nasopharyngeal carcinoma developed clubbing and hypertrophic osteoarthropathy 6 months before radiological detection of secondary deposits in the lung. Another patient with nasopharyngeal carcinoma developed digital clubbing and hypertrophic osteoarthropathy 6 months after the discovery of lung metastases. Development of a paraneoplastic syndrome in the form of hypertrophic osteoarthropathy and digital clubbing is very rare. This manifestation of nasopharyngeal cancers is presented, with a short review of its biology and pathogenesis.- - - - - - - - - - ranking = 0.5keywords = carcinoma (Clic here for more details about this article) |
5/52. Pamidronate-induced remission of pain associated with hypertrophic pulmonary osteoarthropathy in chemoendocrine therapy-refractory inoperable metastatic breast carcinoma.We describe an extremely rare case of a woman with pulmonary metastatic disease from breast cancer, who presented with features of hypertrophic pulmonary osteoarthropathy (HPOA). pain associated with HPOA may be extremely disabling and resistant to treatment. Treatment with pamidronate, an inhibitor of osteoclastic bone resorption, given every 2 weeks by i.v. drip infusion, led to rapid disappearance of uncontrolled pain caused by HPOA.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
6/52. Tumor debulking by radiofrequency ablation in hypertrophic pulmonary osteoarthropathy associated with pulmonary carcinoma.A 73-year-old male with stage IV lung adenocarcinoma presented with leg swelling and clubbing of the fingers on both hands upon physical examination, and bone scintigrams demonstrated marked accumulation of 99mTc-MDP in the long bones adjacent to the patellae. A diagnosis of hypertrophic pulmonary osteoarthropathy associated with primary lung cancer was made. Radiofrequency ablation (RFA) was utilized for cytoreduction, because the patient refused chemotherapy. One-month follow-up CT scans revealed low density of the ablated area associated with ablation necrosis. Cytoreduction by RFA rapidly alleviated the arthralgia and swelling, but not the clubbing of fingers. Follow-up bone scintigrams demonstrated a reduction in patellar uptake after RFA.- - - - - - - - - - ranking = 1.25keywords = carcinoma (Clic here for more details about this article) |
7/52. A case of pulmonary adenocarcinoma associated with hypertrophic osteoarthropathy due to vascular endothelial growth factor.A 62-year-old male patient was admitted, because a chest X-ray examination revealed an abnormal shadow (4 cm in diameter) in the left upper lobe. A transbronchial lung biopsy showed the features of adenocarcinoma. Chest and abdominal computed tomography (CT) scan showed the features of lymphangitis carcinomatosa, and bilateral metastatic adrenal tumors. After effective chemotherapy, he complained of arthralgia and a bone scintigram showed abnormal uptakes in his bilateral shoulder, knee and wrist. He was diagnosed with pulmonary hypertrophic osteoarthropathy (PHOA). The serum level of vascular endothelial growth factor (VEGF) was elevated to 424 pg/ml, while serum growth hormone (GH) and GH-releasing hormone were normal. Immunohistochemical analysis showed positive features of VEGF in the pulmonary tumor cells. He died of cachexia on May 2nd, 2001, more than 2 years after the diagnosis of pulmonary adenocarcinoma at stage IV.- - - - - - - - - - ranking = 1.75keywords = carcinoma (Clic here for more details about this article) |
8/52. Hypertrophic osteoarthropathy associated with metastatic phyllodes tumor.Hypertrophic osteoarthropathy (HOA) is a paraneoplastic syndrome consisting of digital clubbing, polyarthralgias, and periostosis that sometimes accompanies primary bronchogenic carcinoma and other pulmonary malignancies. We report a case of HOA as the initial manifestation of pulmonary metastases in a 42-year-old woman with malignant phyllodes tumor of the breast. Since the treatment for malignancy-associated HOA is targeted at the underlying neoplasm, it is important to make the diagnosis in a timely fashion so that appropriate therapy may be initiated without delay. HOA symptoms generally improve, as they did in our patient, if the cancer responds to treatment. The pathophysiology of HOA is poorly understood, but a role for tumor-associated humoral mediators has been postulated. The hypothesized mechanisms underlying HOA are reviewed, and evidence for a prominent role for platelet-derived growth factor in mediating this syndrome is examined. This unusual case illustrates the importance of suspecting HOA in a patient with a history of cancer who presents with otherwise unexplained polyarthralgias.- - - - - - - - - - ranking = 0.25keywords = carcinoma (Clic here for more details about this article) |
9/52. Hypertrophic pulmonary osteoarthropathy associated with disease progression in renal cell carcinoma.Hypertrophic osteoarthropathy (HOA) is a paraneoplastic syndrome characterized by periosteal formation and arthritis and usually accompanied by clubbing ofthe digits. Many malignancies have been associated with HOA/clubbing, most being lung cancer and lung metastatic cancer. We herein present a 53-year-old man with lung metastasis from renal cell carcinoma (RCC). HOA occurred one year after the metastasis. Reviewing the literature, only five cases of RCC with HOA have been reported. If their clinical history was traceable, they consistently had disease progression. We reviewed the pathogenesis of HOA/clubbing and linked the prognosis of RCC to relevant cytokines. Therefore, HOA not only heralds a progression of disease but suggests a probable therapeutic choice by targeting some cytokines.- - - - - - - - - - ranking = 1.25keywords = carcinoma (Clic here for more details about this article) |
10/52. Clubbed fingers and hypertrophic osteoarthropathy in a patient with squamous cell carcinoma of the lung.Hypertrophic osteoarthropathy (HOA) is characterized by clubbed fingers and periosteal new bone formation. Etiologically, it can be divided into primary and secondary HOA, but its pathogenesis is uncertain. We report a 42-year-old male patient who suffered from painful clubbing fingers and toes. Serial examinations revealed periosteal new bone formation in the four limb long bones and a solid mass lesion in the right upper lung field. Pathologic examination of the resected mass lesion showed squamous cell carcinoma. After surgery and chemotherapy, the severity of clubbed fingers decreased and joint pain improved. Follow-up bone scan also suggested regression of the uptake of radioactivity in the four limb bones. We concluded that the HOA in this case was probably caused by lung cancer.- - - - - - - - - - ranking = 1.25keywords = carcinoma (Clic here for more details about this article) |
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