MAHE 2006 SCC
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- Scc lung
- Anaplastic ca lung
- Adeno ca lung
"Symmetrical osteitis of the four limbs, chiefly localized to the phalanges and the terminal epiphyses of the long bones of the forearm and leg, sometimes extending to the proximal ends of the limbs and the flat bones, and accompanied by dorsal kyphosis and joint involvement. It is often secondary to chronic conditions of the lungs and heart. (Dorland, 27th ed)"
Hypertrophic pulmonary osteoarthropathy is a rare disorder that is associated with severe clubbing.
This disorder is characterised by:
- Subperiosteal new bone formation at the distal ends of long bones, metatarsals, metacarpals and proximal phalanges
- Symmetrical arthropathy of adjacent joints
- Clubbing of the fingers
- Gynaecomastia
- The patient may complain of dull aching and sometimes swelling of the wrist and ankles.
Gynecomastia - most commonly with large-cell
Hypercalcemia - most commonly with squamous cell
Hypertrophic pulmonary osteoarthropathy - presents as bilateral pain and tenderness in the legs, especially over the tibias.
Bone scan positive.
X-rays show elevated periosteum without cortical involvement. - most commonly with adenocarcinoma (secondary to PTHrp)
Clubbing of digits
Syndromes according to tumor location:
Pancoast syndrome (superior sulcus tumor) - lower brachial plexopathy,
Horner's syndrome,
shoulder/ulnar distribution of pain.
Horner's syndrome - enophthalmos, ptosis, miosis, ipsilateral loss of sweating, hoarseness due to recurrent laryngeal nerve involvement
Second primary: Patients treated for upper aerodigestive tract tumors (lung, H&N, esophagus) have a 3%/year risk of developing a subsequent cancer.
Category: MAHE 2006 MCQs
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