Tumor debulking by radiofrequency ablation in hypertrophic pulmonary osteoarthropathy associated with pulmonary carcinoma.
A 73-year-old male with stage IV lung adenocarcinoma presented with leg swelling and clubbing of the fingers on both hands upon physical examination, and bone scintigrams demonstrated marked accumulation of 99mTc-MDP in the long bones adjacent to the patellae. A diagnosis of hypertrophic pulmonary osteoarthropathy associated with primary lung cancer was made. Radiofrequency ablation (RFA) was utilized for cytoreduction, because the patient refused chemotherapy. One-month follow-up CT scans revealed low density of the ablated area associated with ablation necrosis. Cytoreduction by RFA rapidly alleviated the arthralgia and swelling, but not the clubbing of fingers. Follow-up bone scintigrams demonstrated a reduction in patellar uptake after RFA.
Kishi
Koji
K
Fifth Department of Internal Medicine, Tokyo Medical University, Kasumigaura Hospital, 3-20-1 Chuou, Ami Inashiki, Ibaraki 300-0395, Japan. koji-k@tokyo-med.ac.jp
Nakamura
Hiroyuki
H
Sudo
Akihiko
A
Kobayashi
Katsuyuki
K
Yagyu
Hisanaga
H
Oh-ishi
Shuji
S
Matsuoka
Takeshi
T
D000230:Adenocarcinoma / Q000150:complications* / Q000601:surgery*; D000368:Aged; D017115:Catheter Ablation; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000601:surgery*; D008297:Male; D010005:Osteoarthropathy, Secondary Hypertrophic / Q000175:diagnosis / Q000209:etiology*