Hypertrophic osteoarthropathy complicating metastatic ovarian adenocarcinoma

This report documents for the first time the association of hypertrophic osteoarthropathy with ovarian adenocarcinoma metastatic to the lung, in a 47-year-old woman who became totally incapacitated by her joint pain. Surgical removal of the lung metastases resulted in prompt relief of her pain. Theories of the pathogenesis of this clinical syndrome are reviewed. They include neurovascular, humoral and estrogenic mechanisms. Pulmonary arteriovenous shunting has also been considered in the pathogenesis. Operation should be considered in all patients who area incapacitated by joint pain associated with metastatic disease in the lungs.