Hypertrophic osteoarthropathy (HPOA) was first described by Pierre-Marie Bamberger [1, 2] and is often associated with lung carcinoma. However, other intrathoracic tumours or non-malignant disease [3] may also occur in association with HPOA. In this patient, HPOA was related to a mediastinal tumour of unknown origin that was intensely avid for FDG. The FDG-PET study did not demonstrate any evidence for distant metastatic disease.