A Case of Hypertrophic Pulmonary Osteoarthropathy with Bronchogenic Carcinoma

Hypertrophic pulmonary osteoarthropathy (HPO) is a cryptogenic syndrome frequently associated with lung cancer. We report an interesting case of HPO and discuss its etiology. A 49 year-old-man with adenocarcinoma of the lung complained of bilateral ankle pain and HPO was diagnosed. Though anti-cancer chemotherapy and irradiation of the primary site reduced the size of the tumor, his ankle pain remained. Immediately after additional mediastinal irradiation was performed, his ankle pain markedly improved. Considering prostaglandin, hormone and CEA data measured before and after treatment as well as the clinical course, we speculate that mediastinal involvement of lung cancer might be a contributing factor in HPO.