Hypertrophic osteoarthropathy from pulmonary metastatic phyllodes tumour of the breast

Fiona J Collinson, A Michael Bilous and Richard F Kefford
Med J Aust 2004; 181 (5): 279-280. || doi: 10.5694/j.1326-5377.2004.tb06272.x
Published online: 6 September 2004

A 28-year-old woman presented with a 3-month history of wrist and ankle pain, lethargy and weight loss. She had clubbing of the fingers (Box 1) and toes. A bone scan (Box 2) and chest x-ray (Box 3) revealed periostosis in the wrists and pulmonary metastases, respectively. Two years earlier she had been diagnosed with a malignant phyllodes tumour of the left breast (Box 4), which was treated by mastectomy and axillary dissection.

Hypertrophic osteoarthropathy (HOA) secondary to pulmonary metastatic phyllodes tumour was diagnosed. HOA is a paraneoplastic syndrome characterised by digital clubbing, polyarthralgia and periostosis.1 The joint pain, resistant to non-opiate and opiate analgesia, responded to intravenous pamidronate. There was no tumour response to chemotherapy with adriamycin and ifosfamide.

Phyllodes tumours are fibroepithelial lesions arising from intralobular breast stroma. They account for less than 1% of breast neoplasms. Treatment is by surgical resection. About 20% of patients with phyllodes tumours develop distant metastases, and long-term survival in these women is rare.2

  • Fiona J Collinson1
  • A Michael Bilous2
  • Richard F Kefford3

  • University of Sydney at Westmead Hospital, Wentworthville, NSW.


  • 1. Landrum ML, Ornstein DL. Hypertrophic osteoarthropathy associated with metastatic phyllodes tumor. Am J Clin Oncol 2003; 26: 146-150.
  • 2. Parker SJ, Harries SA. Phyllodes tumours. Postgrad Med J 2001; 77: 428-435.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.