DOI QR코드

DOI QR Code

뼈 전이로 오인될 수 있는 흉강 외 악성 종양으로 인한 비대성 골관절증의 초기 영상 소견

Early Imaging Findings of Hypertrophic Osteoarthropathy Mimicking Bone Metastasis from Extrathoracic Malignancy

  • 황지연 (순천향대학교 의과대학 부천병원 영상의학과) ;
  • 차장규 (순천향대학교 의과대학 부천병원 영상의학과) ;
  • 윤유성 (순천향대학교 의과대학 부천병원 영상의학과) ;
  • 문아림 (순천향대학교 의과대학 부천병원 병리과)
  • Ji Yeon Hwang (Department of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital) ;
  • Jang Gyu Cha (Department of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital) ;
  • Yu Sung Yoon (Department of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital) ;
  • Ahrim Moon (Department of Pathology, Soonchunhyang University College of Medicine, Bucheon Hospital)
  • 투고 : 2020.08.24
  • 심사 : 2020.11.07
  • 발행 : 2021.11.01

초록

비대성 골관절증은 곤봉지, 근막골형성 및 윤활막 삼출액을 특징으로 하는 증후군이다. 이차성 비대성 골관절증은 대부분의 경우 흉부 내 악성 종양과 연관이 있으나, 드물게 흉강 외 악성 종양에 의해 발생할 수 있다. 이에 우리는 유방암의 과거력이 있는 환자에서 발생한 비대성 골관절증의 초음파, 전산화단층촬영, 자기공명영상 및 뼈 신티그래피의 초기 영상의학적 소견에 대해 서술하고자 한다. 악성 종양으로 오인된 본 증례의 모호한 임상 및 영상 소견은 독자에게 흥미롭고 유익할 것으로 생각된다.

Hypertrophic osteoarthropathy (HOA) is a syndrome characterized by digital clubbing, periosteal bone formation, and synovial effusions. Secondary HOA is associated with intrathoracic malignancy in most cases; however, in rare cases, HOA can be caused by extrathoracic conditions. We report early ultrasound, computed tomography, magnetic resonance imaging, and bone scintigraphy findings of HOA in a patient with breast cancer. Its ambiguous clinical and imaging findings that mimicked malignant conditions are particularly interesting and informative.

키워드

참고문헌

  1. Yap FY, Skalski MR, Patel DB, Schein AJ, White EA, Tomasian A, et al. Hypertrophic osteoarthropathy: clinical and imaging features. Radiographics 2017;37:157-195
  2. Collinson FJ, Bilous AM, Kefford RF. Hypertrophic osteoarthropathy from pulmonary metastatic phyllodes tumour of the breast. Med J Aust 2004;181:279
  3. Silveira LH, Martinez-Lavin M, Pineda C, Fonseca MC, Navarro C, Nava A. Vascular endothelial growth factor and hypertrophic osteoarthropathy. Clin Exp Rheumatol 2000;18:57-62
  4. Pegram MD, Reese DM. Combined biological therapy of breast cancer using monoclonal antibodies directed against HER2/neu protein and vascular endothelial growth factor. Semin Oncol 2002;29:29-37
  5. Nasir A, Holzer TR, Chen M, Man MZ, Schade AE. Differential expression of VEGFR2 protein in HER2 positive primary human breast cancer: potential relevance to anti-angiogenic therapies. Cancer Cell Int 2017;17:56
  6. Adams J, Carder PJ, Downey S, Forbes MA, MacLennan K, Allgar V, et al. Vascular endothelial growth factor (VEGF) in breast cancer: comparison of plasma, serum, and tissue VEGF and microvessel density and effects of tamoxifen. Cancer Res 2000;60:2898-2905
  7. Sainani NI, Lawande MA, Parikh VP, Pungavkar SA, Patkar DP, Sase KS. MRI diagnosis of hypertrophic osteoarthropathy from a remote childhood malignancy. Skeletal Radiol 2007;36 Suppl 1:S63-S66
  8. Adams B, Amin T, Leone V, Wood M, Kraft JK. Primary hypertrophic osteoarthropathy: ultrasound and MRI findings. Pediatr Radiol 2016;46:727-730
  9. Griffith JF, Chan DP, Kumta SM, Chow LT, Ahuja AT. Does Doppler analysis of musculoskeletal soft-tissue tumours help predict tumour malignancy? Clin Radiol 2004;59:369-375
  10. Lin PP, Patel SR. Bone sarcoma. New York: Springer 2013:14