[Clubbed fingers and arthralgia as a reversible paraneoplastic syndrome (Pierre-Marie-Bamberger syndrome) in non-small-cell bronchial carcinoma].
METHODS
During chemotherapy for a non-small-cell bronchial carcinoma with metastasis to the right femur (previously locally excised), a 34-year-old man suddenly developed severe, lasting joint pain in the ankle, knee, elbow and wrist without signs of increased warmth or swelling of these joints. At the time of diagnosis clubbed fingers had been noted.


METHODS
Radiography of the hands showed bilateral periosteal hyperostoses. Computed tomography of the thorax revealed tumor progression.


METHODS
The triad of clubbed fingers, periosteal hyperostoses and arthralgia/arthritis with the pulmonary findings established the diagnosis of hypertrophic pulmonary osteoarthritis (HPO; Marie-Bamberger syndrome). Initially there had merely been the signs of the much more frequent incomplete form with only the clubbed fingers, the complete form developing with progression of the disease during chemotherapy, joint pains dominating the symptoms. After right upper lobectomy (primary adenocarcinoma) the joint pains ceased and the finger clubbing regressed.


CONCLUSIONS
Only 10% of non-small-cell bronchial carcinomas are associated with HPO. Conversely, such a tumor is found in 90% of HPO of recent onset and should therefore be sought of when searching for the primary tumor. The signs of HPO are reversible if the underlying disease is adequately treated.
Fietz
T
T
Medizinische Klinik III, Universitätsklinikum Benjamin Franklin, Freie Universität, Berlin. toffi001@zedat.fu-berlin.de
Schneider
P
P
Knauf
W U
WU
Thiel
E
E
D000328:Adult; D018771:Arthralgia; D002283:Carcinoma, Bronchogenic / Q000150:complications* / Q000556:secondary / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000556:secondary / Q000601:surgery; D005266:Femoral Neoplasms / Q000556:secondary / Q000601:surgery; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D008297:Male; D010005:Osteoarthropathy, Secondary Hypertrophic / Q000209:etiology*; D010257:Paraneoplastic Syndromes / Q000209:etiology*