Yang Wen-Chi, Lin Shih-Chang, Liu Ta-Chih, Chen Chung-Jen, Yen Jeng-Hsien, Ou Tsan-Teng, Liu Hong-Wen, Tsai Wen-Chan
Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2003 Apr;19(4):183-7. doi: 10.1016/S1607-551X(09)70469-3.
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.
肥大性骨关节病(HOA)的特征为杵状指和骨膜新生骨形成。病因上,可分为原发性和继发性HOA,但其发病机制尚不清楚。我们报告一名42岁男性患者,他患有疼痛性杵状指和杵状趾。系列检查显示四肢长骨有骨膜新生骨形成,右上肺野有实性肿块病变。切除的肿块病变病理检查显示为鳞状细胞癌。手术和化疗后,杵状指的严重程度减轻,关节疼痛改善。随访骨扫描也提示四肢骨骼放射性摄取减退。我们得出结论,该病例中的HOA可能由肺癌引起。