Case Reports

An uncommon presentation of non-small-cell lung cancer with acrometastases to the great toe and index finger


 

Acrometastasis as initial presentation of metastatic cancer is an extremely rare finding. We describe an unusual case of late-stage non-small-cell lung cancer with metastatic lesions to the great toe and index fnger with associated pain in those areas as the only presenting symptom.

Case presentation and summary
A 71-year-old white woman was referred to the emergency department by her primary care physician for necrosis and swelling of the left great toe for work-up of possible osteomyelitis (Figure 1). Before she presented to her physician, she had been complaining of severe pain, swelling, and erythema of the left great toe that had lasted for 1-2 months. Infection was initially suspected. She completed 2 courses of oral antibiotics with no improvement. She was also complaining of similar symptoms on the left index finger and attributed her symptoms to an injury a month earlier (Figure 2). The pain was so severe that she was not able to bear weight on her left foot. An outpatient X-ray of her left great toe raised her physician’s concerns that it might be osteomyelitis so she was referred to the emergency department.

Click on the PDF icon at the top of this introduction to read the full article.

Recommended Reading

Cola enhances absorption of erlotinib in NSCLC
MDedge Hematology and Oncology
Study evaluates which prior cancers pose a risk for developing NSCLC
MDedge Hematology and Oncology
NSQIP calculator shown inadequate to stratify risk in stage I non–small cell lung cancer.
MDedge Hematology and Oncology
Occult micrometastases in N2 lymph nodes correlated with shorter survival in NSCLC
MDedge Hematology and Oncology
Quitting smoking plus low-dose helical CT reduces lung cancer death risk
MDedge Hematology and Oncology
Serious complications after cancer surgery linked to worse long-term survival
MDedge Hematology and Oncology
Wanted: Better evidence on fast-track lung resection
MDedge Hematology and Oncology
Does sharing genetic risk change behavior?
MDedge Hematology and Oncology
CT of chest, extremity effective for sarcoma follow-up
MDedge Hematology and Oncology
Impact of trimodality treatment on patient quality of life and arm function for superior sulcus tumors
MDedge Hematology and Oncology