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Hypertrophic osteoarthropathy in childhood malignancy
1Department of Paediatric Radiology, Academic Hospital, University of Amsterdam, The Netherlands.
Medical and Pediatric Oncology
|January 1, 1993
Summary
Hypertrophic osteoarthropathy (HOA) is rare in children, often linked to lung or heart issues. This study highlights its rare association with childhood cancers, particularly nasopharyngeal carcinoma, suggesting HOA can precede cancer symptoms.
Area of Science:
- Pediatric Endocrinology
- Pediatric Oncology
- Rheumatology
Background:
- Hypertrophic osteoarthropathy (HOA) is a rare condition in children, distinct from its more common adult presentation.
- Primary HOA is hereditary, while secondary HOA in children is associated with chronic lung diseases, congenital heart defects, and gastrointestinal issues.
- Malignant associations with HOA are infrequent in pediatric cases compared to adults.
Observation:
- The authors report two cases of nasopharyngeal carcinoma associated with HOA in children.
- Literature review identified 24 pediatric cases (under 18) with malignancy and HOA between 1890-1990.
- Nasopharyngeal carcinoma was the most common malignancy (10 cases), followed by osteosarcoma (8 cases).
Findings:
- HOA in pediatric cancer patients, especially those with thoracic malignancies, can precede pulmonary symptoms by 1-18 months.
- The appearance of HOA in conjunction with nasopharyngeal carcinoma indicated a poor prognosis in the reported cases.
- HOA symptoms are reversible upon successful treatment of the underlying condition, whether benign or malignant.
Implications:
- HOA may serve as an early predictive marker for underlying malignancy in children, particularly thoracic cancers.
- Recognizing HOA in children warrants a thorough investigation for potential neoplastic causes.
- The reversibility of HOA post-treatment underscores the importance of early diagnosis and intervention for both HOA and associated conditions.