PDF(Pubmed)
Abstract：
Hypertrophic osteoarthropathy (HOA) is a paraneoplastic syndrome, the exact pathogenesis of which remains to be elucidated. The case of a 69-year-old man who developed intractably painful HOA secondary to lung cancer is presented. Contrast-enhanced computed tomography of the chest showed an 80-mm solid nodule with a large low-density area. The patient was diagnosed as having stage IIIA undifferentiated non-small cell lung cancer. The combination of carboplatin and paclitaxel with bevacizumab reduced tumor size and plasma vascular endothelial growth factor (VEGF) levels, relieving his leg pain. On immunohistochemical examination, lung cancer cells were positive for VEGF. A hypoxic tumor microenvironment may have caused some lung cancer cells to express hypoxia-inducible factor-1α, which contributed, at least in part, to the production of VEGF. The deep dermis vessels showed proliferation in the shin, with their thickened walls positive for VEGF. These findings may encourage investigators to explore novel management strategies for painful HOA.
摘要：
肥厚性骨关节病（HOA）是一种副肿瘤综合征，其确切的发病机制仍有待阐明。介绍了一名69岁男子的病例，该男子发展为继发于肺癌的顽固性疼痛性HOA。胸部对比增强计算机断层扫描显示80毫米实性结节，低密度面积大。患者被诊断为患有IIIA期未分化非小细胞肺癌。卡铂和紫杉醇联合贝伐单抗可降低肿瘤大小和血浆血管内皮生长因子（VEGF）水平，缓解他的腿痛.在免疫组织化学检查中，肺癌细胞VEGF阳性。缺氧的肿瘤微环境可能导致某些肺癌细胞表达缺氧诱导因子-1α，做出了贡献，至少在某种程度上,VEGF的产生。真皮深层血管显示胫骨增生，其增厚的壁VEGF阳性。这些发现可能会鼓励研究人员探索痛苦的HOA的新管理策略。
