Lung cancer with hypertrophic pulmonary osteoarthropathy mimicking acromegaly

Lung cancer is known to be common in old ages. Hypertrophic pulmonary osteoarthropathy (HPOA) also appeared to be rare with pulmonary malignancies. We report a case of middle-aged man with lung cancer with HPOA mimicking acromegaly. Simple X-rays for hand, foot, leg and thigh showed periosteal proliferation of new bone. Whole body bone scan showed increased and diffuse uptake along cortical margins of diaphysis and metaphysic of both femurs and both tibias. Serum IGF-1 level was normal. The peripheral needle approached biopsy was performed for 4.5 cm sized tumor in right upper lobe of lung. The biopsy specimen showed adenocarcinoma. HPOA may exist uncommonly in a secondary form associated with pulmonary malignancies and is a rare paraneoplastic manifestation.