The vast majority of cases of Hypertrophic osteoarthropathy are associated with intra thoracic neoplasms mainly broncogenic cancer and benign fibrous tumor. Less commonly extra thoracic pathologies can present with this disorder. Two cases are presented here. The first is a 50-years-old male who came with complaints of significant weight loss, chest symptoms and multiple upper extremities joint pain. The second case was a 44 years old female who presented similarly with chest symptoms, joint and bone pain limited to lower extremities bilaterally. Chest x-ray and x-ray of extremities were suggestive of secondary hypertrophic ostroarthropathy and intrathoracic masses. The first patient with bronchogenic carcinoma, bronchoscopy with biopsy conform the diagnosis. The second patient was operated and the operative biopsy result was consistent with benign pleural fibroma.
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