EC Pulmonology and Respiratory Medicine

Scar carcinoma is an uncommon form of bronchogenic carcinoma arising in areas of prior pulmonary fibrosis or scarring and may rarely present with hypertrophic pulmonary osteoarthropathy (HPOA), a paraneoplastic syndrome characterized by digital clubbing, bilateral, symmetrical periostitis of long bones and noninflammatory arthritic pain and swelling. We report the case of a 70-year-old male smoker with the history of treatment completed tuberculosis who presented with chronic cough, progressive dyspnea, painful swelling of the small joints of both hands, wrists and ankles, and digital clubbing. Radiography and computed tomography of the chest demonstrated a spiculated mass arising within a fibrotic scar in the left mid lung. Histopathological examination following CT guided FNAC confirmed adenocarcinoma of the lung associated with scar tissue. No distant metastases were identified. This case highlights the importance of considering underlying lung malignancy in patients presenting with HPOA and clubbing. Early recognition of scar carcinoma is essential because delayed diagnosis may occur when symptoms are attributed solely to chronic pulmonary fibrosis or inflammatory disease. Awareness of this rare association can facilitate timely investigation, accurate staging, and improved multidisciplinary management in high-risk patients with unexplained musculoskeletal manifestations and clubbing symptoms.

Keywords: Hypertrophic Pulmonary Osteoarthropathy (HPOA); Hypertrophic Osteoarthropathy (HOA); Platelet-Derived Growth Factor (PDGF); Vascular Endothelial Growth Factor (VEGF)

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