Metastatic tumors of the hand: A report of six cases

Wu, Kao; Guise, Edwin R

doi:10.1016/s0363-5023(78)80091-4

Cited by 85 publications

(54 citation statements)

References 14 publications

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“…In particular, hind/midfoot pain should alert the treating physician to the potential of a metastatic lesion and it should be investigated promptly. Bronchogenic cancer has been implicated in other studies as accounting for 50% of acrometastases 11,12 while the case review by Libson et al suggested that only 15% of pedal metastasis resulted from a bronchogenic primary tumour. 13 The majority of primary malignancies in our series were of infradiaphragmatic origin, highlighting that most primary cancers should be considered as having the potential to metastasise to the foot.…”

Section: Discussionmentioning

confidence: 99%

Delayed diagnosis in metastatic lesions of the foot

Evans

Ramasamy

Jeys

et al. 2014

annals

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INTRODUCTION Pedal acrometastases are a rare complication of disseminated malignancy. To date, there is little in the literature documenting their clinical course. METHODS Our large orthopaedic oncology database was used to review the clinical course of symptomatic pedal acrometastases. RESULTS A total of 15 cases of pedal acrometastases were identified from 2,595 patients with metastases. The median age at presentation was 64.5 years (range: 14-83 years) and the median length of foot symptoms (predominantly pain and swelling) prior to diagnosis of metastasis was 16 weeks (range: 6-104 weeks). The median survival following diagnosis was 4.6 months (range: 2.3-104.5 months). CONCLUSIONS This study suggests that 0.58% of all osseous metastases involve the foot, and that symptoms of foot pain and swelling are often misdiagnosed, leading to delays in treatment. A high index of suspicion is required to diagnose pedal acrometastases early, thereby allowing early treatment so that the patient's quality of life can be maintained prior to death.

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Section: Discussionmentioning

confidence: 99%

Delayed diagnosis in metastatic lesions of the foot

Evans

Ramasamy

Jeys

et al. 2014

annals

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“…Osseous metastases to the hand and wrist, however, are rare, occurring in only 0.007-0.1% of cases [4,5]. Most of these are preterminal events; they are frequently a manifestation of known malignancy and widespread metastases [ 1,6,7].…”

Section: Discussionmentioning

confidence: 99%

“…Most of these are preterminal events; they are frequently a manifestation of known malignancy and widespread metastases [ 1,6,7]. The cases presented in this report represent examples of the uncommon circumstance of acrometastasis appearing as the initial sign of malignancy [1,4,5,8,9]. Although this is an unusual occurrence, it is important to be aware of the possibility of an initial acrometastasis, because it may mimic other skeletal lesions such as infection or inflammatory arthritis both clinically and radiographically [1,4].…”

Section: Discussionmentioning

confidence: 99%

Occult malignancy presenting as metastatic disease to the hand and wrist

Abrahams

1995

Skeletal Radiol.

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Osseous metastases to the hand and wrist are uncommon. Most cases represent the manifestation of known malignancy with disseminated disease. Less commonly, acrometastases are the initial presentation of malignancy. In both instances, diagnosis of malignancy is frequently not considered either clinically or radiographically. This results in a delay in diagnosis and in inappropriate therapy. Three cases of occult malignancy presenting as acrometastases are reported. The author stresses the importance of considering this diagnosis when faced with any aggressive lytic or blastic lesion of the hand and wrist in a patient in the fifth decade of life or older.

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“…This is probably because arterial flow is greatest in this area of the hand (Mulvey 1964). No one digit is preferentially involved (Wu and Guise 1978). The carpus is less commonly affected, being involved in only 10% of cases in two large studies of bone metastases to the hand and wrist (Healey et al 1986;Kerin 1983;Libson et al 1987).…”

Section: Metastasismentioning

confidence: 99%

“…33) (Abrahams 1995). Periosteal reaction is uncommon (Healey et al 1986;Libson et al 1987;Wu and Guise 1978;Chung 1983;Kerin 1958;Mulvey 1964). A soft tissue component is frequent (Libson et al 1987).…”

Section: Metastasismentioning

confidence: 99%