HYPERTROPHIC OSTEOARTHROPATHY; REPORT OF A CASE ASSOCIATED WITH A CHORDOMA OF THE BASE OF THE SKULL AND LYMPHANGITIC PULMONARY METASTASES

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Abstract
A 21-yr.-old, white, male with negative past history became ill with headaches, gas-tro-intestinal symptoms, fever, weakness, and weight loss. Headaches and gastro-intestinal symptoms subsided; fever, weakness, and wt. loss continued for 2 mos. There then developed pain in the limbs with rapidly developing hypertrophic osteoarthropathy of long bones and clubbing of fingers and toes. The patient also presented trismus, right torticollis and deafness of right ear. This was followed by cough with expectoration and X-ray evidence of bilateral pulmonary infiltration. Death occurred 6 mos. after onset of symptoms. Autopsy disclosed a malignant chordoma arising at the base of the skull in the region of the sella turcica, and infiltrating the pituitary gland, pharyngeal vault and surrounding neural structures. There were lymphangitic metastases to both lungs and mediastinal glands. All long bones showed enormous periosteal thickening.

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