Richard Stratton, MD, and colleagues at London's Royal Free Hospital report the case of a 74-year-old woman. For four months, she'd noticed lumpy areas developing in her palms.
Very soon after this, her palms began to thicken severely and her hands began to contract. This caused a "groove sign" -- a deepening of palm lines -- to appear in the upper part of her palm. Her fingers also became swollen at the joints.
Stratton's team diagnosed PFPAS. Knowing its link to cancer, they found a mass in her pelvis. It turned out to be ovarian cancer .
After six months of chemotherapy, the woman's hands improved, but she was left with severely curled palms and fingers.
Stratton and colleagues note that PFPAS has been linked not only to cancer of the ovaries, but also to cancers of the prostate , blood, lung, breast, and pancreas.
What's the link? Researchers aren't sure. Stratton and colleagues suggest that a chemical signal in the body, called connective tissue growth factor or CTGF, might play a role. The factor may help cancers spread while also causing overgrowth of connective tissues in the palm.
Indeed, Stratton's patient had unusually high levels of CTGF -- the first time this factor was measured in a patient with PFPAS and cancer.
Stratton and colleagues report their findings in the September issue of the Journal of the Royal Society of Medicine.
By Daniel DeNoon
Reviewed by Louise Chang
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