A 44 year old man goes to his physician for an employment physical examination. The clinician notices that the patient’s fingers are clubbed. He also demonstrates tenderness over the distal ends of the radius, ulna, and fibula. This patient should be explicitly evaluated to exclude which of the following?
Correct Answer: Lung cancer
Description: This patient has the finger clubbing and hyperophic pulmonary osteoahropathy that can be associated with bronchogenic carcinoma (other than squamous cell carcinoma), benign mesothelioma, and diaphragmatic neurilemmoma. X-ray of the bones generally shows formation of new periosteal bone; ahritis may be present. The etiology of these changes remains a mystery. An ale clinician may identify a cancer at an earlier, potentially curable stage by investigating a possible paraneoplastic syndrome. Ref: Imboden J.B. (2013). Chapter 56. Rheumatic Manifestations of Malignancy. In J.B. Imboden, D.B. Hellmann, J.H. Stone (Eds), CURRENT Diagnosis & Treatment: Rheumatology, 3e.
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