Osteolysis of hand bones due to metastatic deposits from colon cancer: A case report

Abstract

Despite the availability of an efficient screening protocol review, colon cancer is a leading health problem of the world population. At the time of diagnosis about 25% of cases have distant metastases. Distant metastases are most frequently metastases in the liver, lungs, brain, but they are rare in the bones. An early diagnosis of secondary deposits in the bones of the hand can be very difficult. The symptoms are subclinical or similar to other bone diseases. They appear in the advanced disease, and treatment is palliative. The treatment (radiotherapy, chemotherapy, surgery) is determined according to the general condition of the patient and the localization of the lesion. Radiotherapy can reduce tumor mass and reduce pain especially among patients with multiple lesions or inoperable ones. The aim of this paper was to: (1) present a case of secondary deposits of adenocarcinoma of the colon in the hand bones, (2) present the incidence, (3) give differential diagnoses and (4) describe the air treatment by unconventional regime of fractionation. The approach to the treatment of metastatic hands must be multi-disciplinary including an orthopedist, radiologist, oncologist and pathologist. It is important to know the importance of early recognition of these lesions.

Considerations on surgery invasiveness and response and toxicity patterns in classic palliative radiotherapy for acrometastases of the hand: a hint for a potential role of stereotactic body radiation therapy? A case report and literature review

“…For example, the clinical results achieved through 30 Gy in 10 fractions ranged from good symptom palliation in three cases (two metacarpal, one phalangeal), modest pain control in another report with metastatic involvement of a distal phalanx, and to no significant benefit with even worsening of swelling in another patient with bilateral carpal bone metastases ( 6 , 24 – 27 ). In another case of thumb metastasis, a 30 Gy dose produced a symptomatic improvement, along with soft tissue edema as a collateral event ( 28 ). Longer dose fractionation schemes (54 Gy in 27 fractions and 40 Gy in 20 fractions) were equally effective, but more treatment sessions could potentially discomfort patients in terms of compliance with the RT schedule ( 27 , 29 ).…”

Lumbar Pain As Unusual Presentation of Bone Marrow Metastatic Replacement by Colon Carcinoma

“…Colorectal cancer can spread by lymphatic and hematogenous dissemination, as well as through contiguous and transperitoneal routes. Approximately 20% of individuals with colorectal cancer have distant metastatic disease at the time of presentation, the most common metastatic sites being regional lymph nodes, liver, lungs, and peritoneum but rarely in the bones . Although infrequent, there are several reports in literature of colorectal cancer diffusely involving bone marrow, in the case of primary presentation or even infectious complications of unknown underlying disease (e.g., paravertebral abscess) .…”