Das Marie-Bamberger-Syndrom als Fingerzeig auf ein NSCLC: vier Fälle im Lichte der aktuellen Literatur

Zusammenfassung

Das Marie-Bamberger-Syndrom (Synonym: hypertrophe pulmonale Osteoarthropathie) tritt mit einer Inzidenz von 1 – 5 % bei Patienten mit nichtkleinzelligem Bronchialkarzinom (NSCLC) auf. In seiner vollständigen Form treten Trommelschlegelfinger (meist ohne Vorliegen einer Zyanose) und Knochen- und Gelenkschmerzen auf. Anhand der hier dargestellten Fälle wird verdeutlicht, dass dieses paraneoplastische Syndrom zeitlich vor typischen Tumorsymptomen auftritt, jedoch auch heute noch selten erkannt wird. Wird die Symptomkonstellation Trommelschlegelfinger und Knochenschmerz frühzeitig erkannt, lässt sich ein NSCLC in einem früheren Tumorstadium diagnostizieren – daher ist es von großer klinisch-praktischer Bedeutung. Neben der Falldarstellung gibt der Artikel einen Überblick über die aktuellen Vorstellungen zur Pathogenese und Therapie dieses Syndroms.

Abstract

Hypertrophic pulmonary osteoarthropathy (often referred to as Marie-Bamberger syndrome) occurs in 1 – 5 % of all patients with non-small cell lung cancer (NSCLC) as a paraneoplastic syndrome. The complete syndrome is characterised by clubbing of the fingers and toes (often without hypoxia) and pain in the joints and tubular bones. On the basis of four clinical cases, this article shows that this syndrome can precede tumour-specific symptoms and that it is still often overlooked by physicians. An early suspicion of this syndrome is of great clinical value because it can lead to a diagnosis of NSCLC at an earlier tumour stage. In addition to the case reports, the current literature on hypertrophic pulmonary osteoarthropathy is reviewed in this article, with special reference to pathogenetic concepts und to therapeutic options.

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