A Case of Pulmonary Hypertrophic Osteoarthropathy (PHO) Associated With Primary Lung Cancer.

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Background: Although about 3-10 percent of lung cancers are reported to be associated with pulmonary hypertrophic osteoarthropathy (PHO) in the USA and Europe, reports of these cases are relatively rare in Japan. Case: A 75-year-old man was admitted to our hospital with bilateral pretibial edema, joints pain, and clubbed fingers of the hands. Chest roentgenogram and chest computed tomography scan revealed a mass in the right middle lobe. Transbronchial lung biopsy yielded, a diagnosis of moderately differentiated adenocarcinoma. Bone scintigram showed marked accumulation in the knee joint and the lower limbs. These findings yielded a diagnosis of PHO associated with primary lung cancer. Elevated serum levels of LH, FSH, PRL were also detected. The joint pain and bilateral pretibial edema rapidly improved soon after resection of the primary lesion. The serum levels of LH, FSH, PRL decreased, and accumulation on bone scintigram was improved. Conclusion: Bone scintigram and hormone assay are effective for both diagnosing and monitoring the therapeutic outcome of PHO.
特定非営利活動法人日本肺癌学会の論文