Location

Philadelphia, PA

Start Date

11-5-2022 1:00 PM

End Date

11-5-2022 4:00 PM

Description

Cancer metastasis to the bone distal to the knee or elbow, also known as acrometastasis, is a rare but known finding in diffuse malignancy. We report a case of acrometastasis to the left second phalanx in a 70-year-old woman with a history of invasive breast carcinoma that was in remission for four years. On initial encounter in the emergency department, she had pain and swelling over the proximal (PIP) and distal interphalangeal (DIP) joints with a lytic appearance on radiographs. A subsequent Adler PET scan demonstrated previously unknown metastatic disease in the right lower lung, mediastinal and hilar lymph nodes, and left adrenal gland. Successful ray amputation of the affected finger was performed to improve quality of life. Given the poor prognosis, the patient elected to return to her country of origin for treatment and palliative care with her family. A review of the literature signifies how acrometastasis is a rare presentation of malignancy, but often may be the first presenting symptom to suggest metastatic disease.

Embargo Period

6-1-2023

Available for download on Thursday, June 01, 2023

COinS
 
May 11th, 1:00 PM May 11th, 4:00 PM

Acrometastasis as a rare presentation of diffuse malignancy

Philadelphia, PA

Cancer metastasis to the bone distal to the knee or elbow, also known as acrometastasis, is a rare but known finding in diffuse malignancy. We report a case of acrometastasis to the left second phalanx in a 70-year-old woman with a history of invasive breast carcinoma that was in remission for four years. On initial encounter in the emergency department, she had pain and swelling over the proximal (PIP) and distal interphalangeal (DIP) joints with a lytic appearance on radiographs. A subsequent Adler PET scan demonstrated previously unknown metastatic disease in the right lower lung, mediastinal and hilar lymph nodes, and left adrenal gland. Successful ray amputation of the affected finger was performed to improve quality of life. Given the poor prognosis, the patient elected to return to her country of origin for treatment and palliative care with her family. A review of the literature signifies how acrometastasis is a rare presentation of malignancy, but often may be the first presenting symptom to suggest metastatic disease.