Clubbed Fingers and Hypertrophic Osteoarthropathy in a Patient with Squamous Cell Carcinoma of the Lung

增生性骨病變─個案報告

楊文祺(Wen-Chi Yang) ； 林世昌(Shih-Chang Lin) ； 劉大智(Ta-Chih Liu) ； 陳忠仁(Chung-Jen Chen) ； 顏正賢(Jeng-Hsien Yen) ； 歐燦騰(Tsan-Teng Ou) ； 劉宏文(Hong-Wen Liu) ； 蔡文展(Wen-Chan Tsai)

《The Kaohsiung Journal of Medical Sciences》 19卷4期 (2003/04) Pp. 183-187

摘要

增生性骨病變具杵狀指及骨邊緣新骨生成等特色。以病因學來說，可分為原發性及次發性增生性骨病變。然而，其致病機轉目前仍不明。本文報告一位42歲男性罹患具疼痛的杵狀手指及腳趾，經詳細檢查，發現全身X光及骨骼掃描呈現四肢長骨骨周圍新骨形成，且在胸部X光及胸部電腦斷層發現在右胸上葉有一腫瘤，病理檢查報告為鱗狀細胞癌，經腫瘤切除及化學治療後，杵狀指的程度減少且關節疼痛改善，這與體骼掃描中發現四肢骨骼吸收減少可相吻合。因此可說明造成此患者產生增生性骨病變的病因為惡性肺腫瘤。

關鍵字

增生性骨病變，杵狀指，骨邊緣新骨，鱗狀細胞癌

並列摘要

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.

並列關鍵字

hypertrophic osteoarthropathy, clubbing fingers, squamous cell carcinoma, periosteal new bone formation