Metastasis from lung carcinoma to the finger: A case report

Keywords:

Acrometastasis ; metastatic tumor ; hand ; cement spacer.


Published online: Apr 24 2019

Charles M.M. Peeters, Taco Gosens

Abstract

Skeletal metastasis in the hand is exceedingly rare. In approximately 10% of the reported cases, it occurs as the primary manifestation of an occult malignancy. The early, correct diagnosis is warranted given the patient’s poor prognosis. Conventional radiographs and MRI are helpful in diagnosis, but histology is needed for confirmation. Due to the usual wide spread malignancy, palliation is the primary goal of treatment. Disarticulation and resection of the affected ray is the most common approach. We present a case of a skeletal metastasis from a lung carcinoma in the fourth digit of the hand and performed a curettage of the metastatic tumor, followed by a stabilization of the middle phalanx with a bone cement spacer and postoperative local radiation. The postoperative pain relief was acceptable and the functional outcome was relatively good, and therefore indicates that this treatment option could be considered in the palliative care setting of acrometastatis.