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Esophageal Adenocarcinoma and Hypertrophic Osteoarthropathy With Improvement Following Resection of Esophageal Cancer

Wechalekar, Mihir D. MBBS, FRACP; Kennedy, Nicholas A. MBBS; Ahern, Michael MD; Slavotinek, John FRANZCR; Smith, Malcolm D. PhD

JCR: Journal of Clinical Rheumatology: September 2011 - Volume 17 - Issue 6 - p 323-324
doi: 10.1097/RHU.0b013e31822e0642
Case Reports

Esophageal cancer usually presents late and carries a grave prognosis. Early diagnosis dramatically improves outcomes, and hence recognition of the varied presenting features, including hypertrophic osteoarthropathy (HOA), may be important. Hypertrophic osteoarthropathy is a rare manifestation of esophageal adenocarcinoma and indeed may herald the presence of this neoplasm, as it did in the case we present. A 59-year-old man presented with signs and symptoms suggestive of inflammatory wrist, ankle, and knee arthritis, and imaging revealed changes of HOA. He reported dysphagia mainly to solids, and endoscopic biopsy showed adenocarcinoma. Cancer resection treatment led to clinical resolution of his musculoskeletal symptoms. This case highlights the importance of recognition of HOA as a feature of this increasingly common cancer.

From the *Rheumatology Unit and †Gastroenterology Unit, Repatriation General Hospital; ‡Medical Imaging, Flinders Medical Center; and §Rheumatology, Southern Adelaide Health Service, Adelaide, South Australia, Australia.

This study has no sources of support.

The authors declare no conflict of interest.

Correspondence: Mihir D. Wechalekar, MBSB, FRACP, Rheumatology Unit, Repatriation General Hospital, Daws Rd, Daw Park, Adelaide, South Australia 5041, Australia. E-mail:

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.