Hypertrophic pulmonary osteoarthropathy as the presenting symptom of non-small cell lung cancer: A case report

Hypertrophic pulmonary osteoarthropathy (HOA) is a disabling condition that may occur secondarily to primary lung carcinoma. Management of joint pain in patients with HOA is challenging, and treatment options are experimental. Here we report an unusual case of HOA in a 54 year-old man who presented with fever, rash and arthralgia as initial symptoms of an underlying non-small cell lung cancer. He did not respond to various treatment modalities including non-steroidal anti-inflammatory drugs (NSAIDs), pamidronate, and octreotide. His pain symptoms only improved once chemotherapy was administered. This case exemplifies the diagnostic and therapeutic challenge in patients with HOA, and underlines the need for further research to better define this disease and appropriately direct therapy. Key words: Osteoarthropathy, secondary hypertrophic; carcinoma, non-small-cell lung; therapy; pamidronate; octreotide.