Paraneoplastic hypertrophic osteoarthropathy: evaluation at 25 years after pneumectomy

Finger clubbing, which involves distal phalanx thickening and nail convexity, has been known since antiquity. Observations made in modern times by Bamberger (1889), Pierre Marie (1890), and other investigators led to identification of various causes of this digital anomaly which can be the first manifestation of a severe organic disease. Undoubtedly, this somatic abnormality, often associated with arthralgia and bone pain (full-blown hypertrophic osteoarthropathy -- HOA), is most often a harbinger of lung cancer. Paraneoplastic HOA is probably the best known and the most extensively studied paraneoplastic syndrome in human pathology. The familial or idiopathic HOA (pachydermoperiostosis) appears at puberty and is not associated with other underlying diseases. We present the case of a 58-year-old male with HOA, associated with spinocellular lung cancer, who survived 25 years after pneumonectomy.