title: Esophageal adenocarcinoma and hypertrophic osteoarthropathy with improvement following resection of esophageal cancer.
abstract: Esophageal cancer usually presents late and carries a grave prognosis. Early diagnosis dramatically improves outcomes, and hence recognition of the varied presenting features, including hypertrophic osteoarthropathy (HOA), may be important. Hypertrophic osteoarthropathy is a rare manifestation of esophageal adenocarcinoma and indeed may herald the presence of this neoplasm, as it did in the case we present. A 59-year-old man presented with signs and symptoms suggestive of inflammatory wrist, ankle, and knee arthritis, and imaging revealed changes of HOA. He reported dysphagia mainly to solids, and endoscopic biopsy showed adenocarcinoma. Cancer resection treatment led to clinical resolution of his musculoskeletal symptoms. This case highlights the importance of recognition of HOA as a feature of this increasingly common cancer.
authors.affiliation: Rheumatology Unit, Repatriation General Hospital, Adelaide, South Australia, Australia. mihir.wechalekar@health.sa.gov.au
authors.forename: Mihir D
authors.initials: MD
authors.lastname: Wechalekar
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Kennedy
authors.forename: Michael
authors.initials: M
authors.lastname: Ahern
authors.forename: John
authors.initials: J
authors.lastname: Slavotinek
authors.forename: Malcolm D
authors.initials: MD
authors.lastname: Smith
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal; D004938:Esophageal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010005:Osteoarthropathy, Secondary Hypertrophic / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging