PATIENT AND OBSERVATION
HB, a 46-year-old male, married father of 3 children, and electrician. He was diagnosed with schizophrenia in the same year. He was put on long-acting injections (LAI).
He is a smoker with 52 packs-year, he doesn’t use alcohol or other psycho-active substances.
The patient reported pain in the hands and knees that he had for 6 months and a swelling in the same joints since a month.
The main functional signs were; weight loss, anorexia, asthenia and myalgia. Clinical signs consisted of swelling in both hands, tenderness in the palpation of the right knee and the 2 legs. The diagnosis of HPO was made by the presence of polyarthritis and finger cubbing. Further examinations were performed to identify the underlying cause of HPO. Routine blood tests were performed objectifying hypocholesterolemia, hypertriglyceridemia, anemia and hypoalbuminemia.
Radiographies of the hands, knees, legs and pelvis had no anomalies. radiographies of arms objectified osteolytic images in both humeri.
A fiberoptic endoscopy was performed with no abnormalities.
A PET-scan was performed objectifying a mediastinal tumor of 8 cm
A biopsy of the tumor objectified a lung squamous cell carcinoma staged T4N3M1c.
The patient is going to start chemotherapy but his prognosis is bad given that the cancer is at an advanced stage.