Rheumatology Unit, Repatriation General Hospital, Adelaide, South Australia, Australia.
J Clin Rheumatol. 2011 Sep;17(6):323-4. doi: 10.1097/RHU.0b013e31822e0642.
Esophageal cancer usually presents late and carries a grave prognosis. Early diagnosis dramatically improves outcomes, and hence recognition of the varied presenting features, including hypertrophic osteoarthropathy (HOA), may be important. Hypertrophic osteoarthropathy is a rare manifestation of esophageal adenocarcinoma and indeed may herald the presence of this neoplasm, as it did in the case we present. A 59-year-old man presented with signs and symptoms suggestive of inflammatory wrist, ankle, and knee arthritis, and imaging revealed changes of HOA. He reported dysphagia mainly to solids, and endoscopic biopsy showed adenocarcinoma. Cancer resection treatment led to clinical resolution of his musculoskeletal symptoms. This case highlights the importance of recognition of HOA as a feature of this increasingly common cancer.
食管癌通常表现较晚,预后严重。早期诊断可显著改善预后,因此认识到各种表现特征,包括肥大性骨关节病(HOA),可能很重要。肥大性骨关节病是食管腺癌的罕见表现,实际上可能预示着这种肿瘤的存在,就像我们提出的这个病例一样。一名 59 岁男性出现了炎症性腕、踝和膝关节关节炎的症状和体征,影像学显示有 HOA 的改变。他报告主要是固体食物吞咽困难,内镜活检显示腺癌。癌症切除治疗导致他的肌肉骨骼症状得到临床缓解。这个病例强调了认识到 HOA 作为这种日益常见的癌症的特征的重要性。