Acrométastase du pouce révélant un adénocarcinome pulmonaire : à propos d'un cas avec revue de la littérature

Digital acrometastase as a primary manifestation of a bronchial adenocarcinoma

“…[4][5][6][7] About 62% are located in the phalanges and 34% in the distal phalanx. 5,8,9 The primary tumors most involved, in descending order of prevalence, are: lung, kidney, breast and digestive tract. 10 Men are more affected than women.…”

“…10 Men are more affected than women. 8,11 Tumor cells migrate to bone by haematogenous route. 5 The pulmonary cells, unlike those coming from the digestive tract, have direct access to the distal arterial system.…”

“…The lesions are rarely osteocondensant or mixed. 8 Other possible differential diagnoses can be evoked: cartilaginous matrix tumors, rheumatoid arthritis and gout. 9,14,17 The absence of a known primary neoplasia, should lead to perform a systematic chest x-ray or even a chest CT scan to look for bronchopulmonary neoplasia even if the patient is asymptomatic.…”

“…9,14,17 The absence of a known primary neoplasia, should lead to perform a systematic chest x-ray or even a chest CT scan to look for bronchopulmonary neoplasia even if the patient is asymptomatic. 8 The management of these patients depends on the extent of the primary tumor. In case of controllable primary tumor with single metastasis, surgical excision can be considered.…”

“…In the case of multiple metastases, palliative treatment is indicated, with radiotherapy, analgesics, anti-inflammatory drugs. 8,18,19 Bisphosphonates or denosumab can also be useful in bone metastases. 20,21 The prognosis of these patients is poor, with a survival rate of only 15% at the end of the first year.…”