Hypertrophic pulmonary osteoarthropathy secondary to bronchial adenocarcinoma and coexisting pulmonary tuberculosis: a case report

A 44-year-old man presented with painful swelling of wrists and ankles, severe pain at both tibiae, clubbing of fingers and toes and arthritis in wrist and ankle joints. The chest roentgenogram showed consolidation of the right lower lobe, whereas plain roentgenograms revealed solid periosteal reaction at both tibiae. CT and bronchoscopy confirmed the presence of adenocarcinoma of the right lower lobe. Moreover, mycobacterium of tuberculosis was isolated by culture of the patient's sputum. Our patient received antituberculous treatment and soon he underwent surgical excision of the tumour and subsequent chemotherapy. Ten months later, he returned with metastatic lesions in the brain and the adrenals. A few days later, he died. The patient suffered from bronchial adenocarcinoma as well as pulmonary tuberculosis. As a complication of these two coexisting conditions, the patient developed hypertrophic pulmonary osteoarthropathy.