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[Swelling of the knee, fatigue]
M Billeter1, E Streit, W Deuel
1Medizinische Poliklinik, Universitätsspital Zürich.
Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
|August 20, 1991
Summary
A patient with lung cancer experienced hypertrophic osteoarthropathy symptoms. Treatment of the lung tumor led to the resolution of bone and joint issues, highlighting a significant cancer-related condition.
Area of Science:
- Oncology
- Rheumatology
- Pulmonology
Background:
- Pierre-Marie-Bamberger syndrome is a rare paraneoplastic condition linking lung cancer and hypertrophic osteoarthropathy.
- Early recognition is crucial for effective management of associated symptoms.
Observation:
- A 43-year-old male presented with fatigue and bilateral knee swelling.
- Clinical examination revealed acropachy and characteristic nail changes.
- Laboratory results indicated leukocytosis, elevated erythrocyte sedimentation rate, and increased alkaline phosphatase.
Findings:
- Radiographic imaging confirmed hypertrophic osteoarthropathy with symmetric metaphyseal periosteal reactions in the femora and tibiae.
- A 5 x 7 cm parahilar mass in the right upper lobe was identified, consistent with lung cancer.
- The diagnosis of Pierre-Marie-Bamberger syndrome was established based on the co-occurrence of lung cancer and hypertrophic osteoarthropathy.
Implications:
- Successful radiotherapy for the lung tumor resulted in the subsidence of osteoarthropathy symptoms.
- Alkaline phosphatase levels normalized post-treatment, correlating with symptom resolution.
- This case underscores the importance of considering paraneoplastic syndromes in patients with unexplained musculoskeletal and systemic symptoms.