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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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.
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PMID:Hypertrophic pulmonary osteoarthropathy associated with disease progression in renal cell carcinoma. 1272 77

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.
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PMID:Clubbed fingers and hypertrophic osteoarthropathy in a patient with squamous cell carcinoma of the lung. 1279 48

Facial pain can, on rare occasions, be the presenting symptom of lung cancer. This report describes a patient with non-metastatic lung cancer, which was associated with attacks of debilitating facial pain, presenting as cluster headache. Moreover, 32 reported cases of lung cancer-related facial pain (including the present one) are reviewed, and their clinical features are summarized. The facial pain is almost always unilateral, and is most commonly localized to the ear, the jaws, and the temporal region. The pain is frequently described as severe and aching, and may be continuous or intermittent. Aggravation and expansion of the pain, digital clubbing, increased erythrocyte sedimentation rate, and hypertrophic osteopathy, may contribute to the diagnosis. Referred pain, due to invasion or compression of the vagus nerve, as well as paraneoplastic syndrome secondary to the production of circulating humoral factors by the malignant tumor cells, is implicated in the pathophysiology of facial pain associated with non-metastatic lung cancer. Radiotherapy and tumor resection with vagotomy are very effective in aborting the facial pain. Thus, lung cancer should be included in the differential diagnosis of facial pain that is atypical and/or refractory to treatment.
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PMID:Facial pain as first manifestation of lung cancer: a case of lung cancer-related cluster headache and a review of the literature. 1455 96

It is also common to observe skin manifestations in many internal malignancies. The lung cancer is a frequently seen internal cancer. Due to its gradually increasing incidence, it has become the first reason of death from cancer also in women by overtaking the breast cancer. Although pathognomonic skin manifestations are not reported in lung cancers, it is emphasized that lung cancer must be remembered when non specific signs such as digital clubbing, hypertrophic osteoatropathy, cyanosis due to superior vena cava syndrome, oedema, telengiectasia, acanthosis nigricans are observed. Because a few reports are present about this subject in literature, 44 patients which had the diagnosis of lung cancer in Cumhuriyet University Faculty of Medicine were evaluated according to the their dermatological manifestations. 47.7% of these patients had digital clubbing; meanwhile 25% telengiectasia of the chest forewall, 22.7% lip cyanosis, 9% long eyelash, 2.27% pruritus, 2.27% hypertrophic pulmonary osteoarthropathy and 2.27% Leser Trelat sign were established.
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PMID:[The skin manifestations in patients with lung cancers]. 1510 Sep

Hypertrophic osteoarthropathy (HOA) is one of the paraneoplastic syndromes most commonly associated with non-small-cell lung cancer. Although pulmonary metastasis is the second most common initial site of melanoma metastasis, HOA is rarely detected in patients with metastatic melanoma in the lung. We report a case of a 45-year-old woman with advanced melanoma who developed HOA after her disease had progressed through first-line systemic therapy. The patient's diagnosis of HOA was made on the basis of digital clubbing, arthralgia, pain, joint effusion and periosteal bone formation on X-ray with negative rheumatologic laboratory studies. Only six cases of HOA in metastatic melanoma have been reported previously. This diagnosis should be considered with lung metastases and the presentation of polyarthralgia with appropriate laboratory and imaging findings. Interestingly, the patient responded to bisphosphonates and second-line chemotherapy with carboplatin and paclitaxel, which is commonly used for lung cancer, not advanced melanoma. As with many paraneoplastic syndromes, successful treatment of the underlying disease was associated with a rapid resolution of the symptoms.
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PMID:Hypertrophic osteoarthropathy associated with metastatic melanoma. 1631 44

The patient was a 39-year-old woman admitted with complaints of fever, clubbed fingers and arthralgia. A chest roentgenogram and chest computed tomographic scan revealed a mass in the left lower lobe. Transbronchial lung biopsy was performed, and a diagnosis of moderately differentiated adenocarcinoma was made. Physical examination confirmed finger clubbing in both hands. Bone scintigram showed marked accumulation of 99mTc-MDP in the long bones, bones of the elbows, and patellae. These findings yielded a diagnosis of pulmonary hypertrophic osteoarthropathy associated with primary lung cancer in young adult. The patient had fever and disturbance of gait of arthralgia on admission, and was treated with an oral non-steroidal anti-inflammation drug (NSAID). Advanced non small cell lung cancer (clinical stage T2 N3 M1, Stage IV) was then diagnosed. Gefitinib was administered after EGFR mutation was found in the tumor specimen. NSAID therapy alleviated the fever and arthralgia. After starting gefitinib and discontinuing the NSAID, She had kept a remission of rational symptom with cytoreductive effect. The abnormal findings of bone scintigrams subsequently disappeared and the patient's serum ICTP dropped.
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PMID:[A case of pulmonary hypertrophic osteoarthropathy associated with primary lung cancer in a young adult successfully treated with gefitinib]. 1735 79

Hypertrophic osteoarthropathy (HOA) is a syndrome characterized by digital clubbing, arthralgias, and tissue swelling and is frequently described in association with bronchogenic carcinoma. The associated pain can be disabling, and symptoms are often resistant to conventional analgesic medications. We present a patient with HOA of the lower extremities and wrists that developed after bronchogenic carcinoma. The pain and swelling completely resolved after a single administration of 4 mg of zoledronic acid. The proposed pathogenesis of HOA and the mechanisms by which bisphosphonates might alleviate symptoms are reviewed.
Clin Lung Cancer 2008 May
PMID:Hypertrophic osteoarthropathy effectively treated with zoledronic acid. 1862 29

Hypertrophic pulmonary osteoarthropathy (HPOA), also known as secondary hypertrophic osteoarthropathy, is a clinical syndrome characterized by proliferative periostitis of the long bones especially in the distal and periarticular aspects, proliferation of the synovial membranes, causing painful and swollen joints, and often with finger clubbing. It is associated with various underlying causes, including pulmonary, pleural, cardiac, abdominal and miscellaneous conditions. Its pulmonary causes include bronchogenic carcinoma, tuberculosis, pulmonary abscess, bronchiectasis, emphysema, etc. Its radiographic presentation involves periostitis in the lower extremities. We report one case that had an incidental finding of HPOA with initial complaint about an incidental solitary knee mass with painful swelling of right knee, leading to early diagnosis of occult bronchogenic carcinoma. The radiographs and magnetic resonance imaging (MRI) revealed periosteal reactions without definite intraosseous lesion. Chest radiography and CT scan disclosed an infiltrating right upper lobe lesion suspicious malignancy. Patient received right S2 segmentectomy of lung with pathological confirmation of adenocarcinoma of lung cancer. It is important for the clinician to be aware of the radiographic findings of periostitis of HPOA, which may be the clues leading to early detection of lung cancer without significant pulmonary symptoms and to avoid possible tumor progression and distant metastases.
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PMID:Incidental solitary knee mass as the first manifestation of hidden lung cancer. 1901 72

Finger clubbing, which involves distal phalanx thickening and nail convexity, has been known since antiquity. Observations made in modern times by Bamberger (1889), Pierre Marie (1890), and other investigators led to identification of various causes of this digital anomaly which can be the first manifestation of a severe organic disease. Undoubtedly, this somatic abnormality, often associated with arthralgia and bone pain (full-blown hypertrophic osteoarthropathy -- HOA), is most often a harbinger of lung cancer. Paraneoplastic HOA is probably the best known and the most extensively studied paraneoplastic syndrome in human pathology. The familial or idiopathic HOA (pachydermoperiostosis) appears at puberty and is not associated with other underlying diseases. We present the case of a 58-year-old male with HOA, associated with spinocellular lung cancer, who survived 25 years after pneumonectomy.
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PMID:Paraneoplastic hypertrophic osteoarthropathy: evaluation at 25 years after pneumectomy. 1977 8

Paraneoplastic osteoarthropathy includes various forms of arthritis syndrome which probably relates to immune mechanisms, and much more often hypertrophic osteoarthropathy(HOA). HOA is often accompanied with primary lung cancer, malignant pleural mesothelioma, chronic pulmonary diseases, cyanotic congenital heart diseases, among others. The presentation of HOA sometimes precedes the diagnosis of underlining malignancies, and consists of finger clubbing, polyarthralgia, and pain and swelling of forearms and lower thighs. Acute onset of the symptoms except for finger clubbing may indicate expansive growth of malignant diseases. Recently, a gene responsible for prostaglandin E2 degradation was identified as a cause of idiopathic HOA. As idiopathic HOA is clinically indistinguishable from paraneoplastic HOA, this discovery may highlight some common biomarkers involved in tumor progression and HOA formation.
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PMID:[Osteoarthropathy]. 2056 2


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