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Hypertrophic Pulmonary Osteoarthropathy Associated with Lung Metastasis of Leiomyosarcoma of the Uterus
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Sug Won Han, Seung Hyun Ann, Kwan Su Hong, Hoon Kyo Kim, Kyung Shik Lee, Dong Jip Kim
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J Korean Cancer Assoc. 1984;16(1):59-67.
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Abstract
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- Hypertrophic pulmonary osteoarthropathy is a syndrome of clubbing fingers or toes, chronic proliferative periostitis of the long bones, and polyarthritis resembling rheumatoid arthritis. Hypertrophic pulmonary osteoarthropathy is most commonly encountered in bronchogenic carcinoma, pleural mesothelioma, metastatic lung 'cancer, bronchiectasis, and lung abscess. The pathogenesis is unknown but estrogen, growth hormone, circulatory factor, and neu- rogenic factor may be associated. The authors experienced a case of hypertrophic pulmonary osteoarthropathy due to lung metastasis of leiomyosarcoma of the uterus. The patient was a 50-year-old female, who had a history of total hysterectomy for the leiomyosarcoma of the uterus in SeP. 1981. Six months later she began to feel clubbing fingers and toes, joint pain and swelling on the wrists, knees, and ankles. One year later cough and chest pain developed. The X-ray of the chest showed multiple round metastatic nodules and the X-ray of the extremities showed thin radiopaque line of new bone formation separated fram the underly- ing denser cartex by a narraw radiolucent band. "Tc radionuclide bone scans revealed the accumulation of radinuclide along the cortex of the long bones and digital ends. The serum level of growth hormone and estradiol was within normal limit. We administered an anti-inflammatory agent such as indomethacin and started the chemo- therapy. The bone pain, soft tissue swelling, and clubbing fingers were markedly improved and the metastatic nodules of the lung were decreased in size.
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