J Rheum Dis.  2014 Oct;21(5):248-252. 10.4078/jrd.2014.21.5.248.

A Case of Hypertrophic Osteoarthropathy Associated with Lung Metastasis of Parotid Gland Mucoepidermoid Carcinoma

• Song ST
• Yoo IS
• Kim Y
• Park CK
• Yun HJ
• Kang SW
• Kim J

• KMID: 2222948
• DOI: http://doi.org/10.4078/jrd.2014.21.5.248

Abstract

Hypertrophic osteoarthropathy is a syndrome characterized by periosteal new bone formation, arthritis, and clubbing of the fingers and toes. The majority of cases occur secondarily to the conditions associated with pulmonary, cardiac, gastrointestinal disorders or other systemic diseases. There are many cases with malignancy worldwide. We report the first patient who had hypertrophic osteoarthropathy due to metastatic cancer after surgical removal for mucoepidermoid carcinoma of the parotid gland.

Keyword

Hypertrophic osteoarthropathy; Mucoepidermoid carcinoma; Parotid gland

MeSH Terms

Arthritis
Carcinoma, Mucoepidermoid*
Fingers
Humans
Lung*
Neoplasm Metastasis*
Osteogenesis
Parotid Gland*
Toes

Figure

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  Figure 1. High grade mucoepidermoid carcinoma with predominant epidermoid cells and pronounced nuclear atypia (H&E ×400).

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  Figure 2. Photograph of the patient's both hands reveals clubbing fingers and round turtile-back-shaped nails.

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  Figure 3. (A) PET image demonstrates a hypermetabolic mass of the right middle lobe (arrow). (B) Transverse CT image shows a large mass (3.2 cm) with internal necrosis in the right middle lobe and a small nodule in the right lower lobe (white arrow).

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  Figure 4. Tc-99m HDP scan finding shows diffuse and symmetrical increased uptakes of radionuclide in a linear pattern along the periosteal surfaces of humerus, ulna, radius, tibia, and fibula.

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  Figure 5. (A) At admission, plain radiograph of lower extremities shows a subtle periosteal reaction on the femur and tibia (white arrows). (B) 1 year later, plain radiograph of lower extremities shows lamellar periosteal new bone formation around the shafts of the femur, tibia, and fibular (white arrows).

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