A Case of Metastatic Lung Cancer to the Distal Phalanx.

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Metastatic carcinoma in the hand is very rare. We now report a case of the metastatic lesion to the distal part of the finger from lung cancer, diagnosed by biopsy as squamous cell carcinoma. A 64-year-old man presented with a swelling and pain of the distal phalanx of the left ring finger. The swelling with blister had increased in size, resulting in ulcer formation. X-rays of the involved finger showed an area of lytic destruction of the distal phalanx. Amputation at the proximal phalanx of the left ring finger was performed, and pain was completely vanished. Histological examination showed well differentiated squamous cell carcinoma, similar to the primary lung lesion. Metastases to the hand from other malignant tumors are very rare, the incidence of hand involvement being 0.2% of all osseous metastases. Clinical manifestations resemble inflammatory diseases, such as whitlow, felon, osteomyelitis or gout. A high degree of suspicion, radiographs and biopsy help to clinch a correct diagnosis. A diagnosis of metastasis to the hand connotes a poor prognosis, proclaiming well-advanced and disseminated disease, which indicates that almost all patients are dead within six months.
西日本整形・災害外科学会の論文