title: [A case of pulmonary hypertrophic osteoarthropathy associated with primary lung cancer in a young adult successfully treated with gefitinib].
abstract: The patient was a 39-year-old woman admitted with complaints of fever, clubbed fingers and arthralgia. A chest roentgenogram and chest computed tomographic scan revealed a mass in the left lower lobe. Transbronchial lung biopsy was performed, and a diagnosis of moderately differentiated adenocarcinoma was made. Physical examination confirmed finger clubbing in both hands. Bone scintigram showed marked accumulation of 99mTc-MDP in the long bones, bones of the elbows, and patellae. These findings yielded a diagnosis of pulmonary hypertrophic osteoarthropathy associated with primary lung cancer in young adult. The patient had fever and disturbance of gait of arthralgia on admission, and was treated with an oral non-steroidal anti-inflammation drug (NSAID). Advanced non small cell lung cancer (clinical stage T2 N3 M1, Stage IV) was then diagnosed. Gefitinib was administered after EGFR mutation was found in the tumor specimen. NSAID therapy alleviated the fever and arthralgia. After starting gefitinib and discontinuing the NSAID, She had kept a remission of rational symptom with cytoreductive effect. The abnormal findings of bone scintigrams subsequently disappeared and the patient's serum ICTP dropped.
authors.affiliation: Department of Respiratory Medicine, The National Hospital Organization Nishi-gunma Hospital.
authors.forename: Hisao
authors.initials: H
authors.lastname: Imai
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tomizawa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ishihara
authors.forename: Noriaki
authors.initials: N
authors.lastname: Sunaga
authors.forename: Haruka
authors.initials: H
authors.lastname: Aoki
authors.forename: Hironobu
authors.initials: H
authors.lastname: Iijima
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Satoru
authors.initials: S
authors.lastname: Watanabe
authors.forename: Ryusei
authors.initials: R
authors.lastname: Saito
authors.forename: Masatomo
authors.initials: M
authors.lastname: Mori
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001842:Bone and Bones / Q000000981:diagnostic imaging; D005260:Female; D000077156:Gefitinib; D018773:Genes, erbB-1; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D009154:Mutation; D010005:Osteoarthropathy, Secondary Hypertrophic / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D011799:Quinazolines / Q000627:therapeutic use*; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D000077156:Gefitinib