【肺多形性癌合并肺肥厚性骨关节病1例】。

Daisuke Ihara, Noboru Hattori, Kouji Yoshioka, Kazunori Fujitaka, Nobuoki Kohno
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摘要

肺癌偶尔伴有肺肥厚性骨关节病(PHO)作为副肿瘤综合征。在此,我们报告一个不典型的多形性癌合并PHO的病例。一名59岁男性患者因双踝咳嗽和关节痛转诊至我院,我们根据骨闪烁图的典型表现诊断为PHO。胸部CT示右肺7cm肿瘤,细胞学诊断为非小细胞癌(cT2N2M0, IIIA期)。肿瘤切除后关节痛及骨显像异常摄取消失。最终病理诊断为多形性癌。在辅助化疗(顺铂加长春瑞滨)期间,发现右胸膜腔病变复发。然而,患者没有报告PHO的症状。在将治疗方案改为卡铂加紫杉醇后,复发的肿瘤完全缓解,该患者目前已存活三年无复发。
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[A case of pulmonary pleomorphic carcinoma accompanied by pulmonary hypertrophic osteoarthropathy].

Lung cancer occasionally accompanies pulmonary hypertrophic osteoarthropathy (PHO) as a paraneoplastic syndrome. Here, we present an atypical case of pleomorhic carcinoma with PHO. A 59-year-old man with cough and arthralgia in both ankles was referred to our hospital and we made a diagnosis of PHO based on the typical findings in bone scintigram. Chest CT showed a 7 cm tumor in the right lung which was cytologically diagnosed as non-small cell cancer (cT2N2M0, stage IIIA). After resection of the tumor, his arthralgia and abnormal uptakes on bone scintigram disappeared. The final pathological diagnosis of the tumor was pleomorphic carcinoma. During adjuvant chemotherapy (cisplatin plus vinorelbine), relapsed lesions in the right pleural space were found. However, no symptoms of PHO were reported by the patient. Following the change of the regimen to carboplatin plus paclitaxel, the relapsed tumor went into complete remission, and this patient has now survived for three years without recurrence.

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