title: Metastasis of hepatocellular and renal cell carcinoma to the hand.
abstract: Malignant carcinoma metastasis to the skeleton is the third most common site of metastasis after lung and liver, usually involving the axial skeleton and the proximal ends of long bones, ribs, and vertebrae. Acrometastasis, metastasis to hands or feet, comprises only 0.1% of all metastases. Here, we present 2 cases of acrometastasis, one from hepatocellular carcinoma and the other from renal cell carcinoma. We describe the presentation, radiographs, surgical treatment, and outcomes for each patient. Patients presented with swelling and pain at the tumor sites and were treated with amputations. The second patient's disease progressed resulting in death shortly after amputation indicating acrometastasis may be a poor prognostic indicator of survival. We review the literature and discuss the importance of disease process recognition and prognosis.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, Calif.; and VA Southern Nevada Healthcare System, and Department of Surgery, University of Nevada School of Medicine, North Las Vegas, Nev.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rommer
authors.affiliation: Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, Calif.; and VA Southern Nevada Healthcare System, and Department of Surgery, University of Nevada School of Medicine, North Las Vegas, Nev.
authors.forename: Solmaz Niknam
authors.initials: SN
authors.lastname: Leilabadi
authors.affiliation: Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, Calif.; and VA Southern Nevada Healthcare System, and Department of Surgery, University of Nevada School of Medicine, North Las Vegas, Nev.
authors.forename: Grace
authors.initials: G
authors.lastname: Lam
authors.affiliation: Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, Calif.; and VA Southern Nevada Healthcare System, and Department of Surgery, University of Nevada School of Medicine, North Las Vegas, Nev.
authors.forename: Ali
authors.initials: A
authors.lastname: Soltani
authors.affiliation: Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, Calif.; and VA Southern Nevada Healthcare System, and Department of Surgery, University of Nevada School of Medicine, North Las Vegas, Nev.
authors.forename: Chandra V
authors.initials: CV
authors.lastname: Ellis
authors.affiliation: Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, Calif.; and VA Southern Nevada Healthcare System, and Department of Surgery, University of Nevada School of Medicine, North Las Vegas, Nev.
authors.forename: Murtaza
authors.initials: M
authors.lastname: Rizvi
authors.affiliation: Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, Calif.; and VA Southern Nevada Healthcare System, and Department of Surgery, University of Nevada School of Medicine, North Las Vegas, Nev.
authors.forename: Alex K
authors.initials: AK
authors.lastname: Wong