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Clinical case A 44 years old woman smoked a pack of cigarettes daily for the last 20 years. Her symptoms started 4 years before the diagnosis. She complained of leg pain that slowly became more intense and finally extended to the arms. Months before her hospitalization the pain was unbearable and it did not abate with analgesics or narcotics. Six months before hospitalization she noticed bulbous deformities “as small light bulbs” at the end of her fingers and toes and she also suffered a loss of 12 kg. The physical examination revealed a pale looking person with normal vital signs and without abnormalities in thorax and abdomen. Prominent digital clubbing and hyperalgesia of tibia and fibula were found. A chest X-ray showed a mass in the apex of the left lung that was corroborated by a CT-scan. The X-rays of the lower extremities showed a radiolucid band under the periosteum of tibias and fibulas and acro-osteolysis of the distal foot phalanges. The CT-scan of head and chest did not reveal metastasis.

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2010-10-07   |   792 visitas   |   Evalua este artículo 0 valoraciones

Vol. 62 Núm.3. Mayo-Junio 2010 Pags. 261-266 Rev Invest Clin 2010; 62(3-ENGLISH)