title: Five cases of acrometastasis to the hand from a carcinoma and review of the literature.
abstract: Metastases in the hand bones are a rare form of cancer presentation. Their appearance as a sign of carcinoma is even rarer and is associated with a poor prognosis. While amputation is recommended in cases of isolated metastases in patients with at least a few months of survival, radiation therapy may be useful for treating pain and partially restoring function. We conducted a retrospective review of 5 consecutive patients (2 male, 3 female; mean age of 46 years) presenting with metastases in the hand bones who had lung (n=2), skin, uterus and kidney cancers. Conservative treatment was performed in three cases, transmetacarpal amputation in one case and distal phalanx amputation in one case. All patients died within a few months of the diagnosis (mean: 5.2months). Because acrometastases generally are related to widespread disease, the prognosis of patients with acrometastases is poor. These cases illustrate the rapid progression of the disease when acrometastases in the hand are present.
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Hospital Clínic and Department of Human Anatomy and Embryology - institut d'Investigació August Pi i Sunyer IDIBAPS, Faculty of Medicine, University of Barcelona, Carrer Villarroel 170, 08036 Barcelona, Spain. Electronic address: e.munoz.mahamud@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Muñoz-Mahamud
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Hospital Clínic and Department of Human Anatomy and Embryology - institut d'Investigació August Pi i Sunyer IDIBAPS, Faculty of Medicine, University of Barcelona, Carrer Villarroel 170, 08036 Barcelona, Spain. Electronic address: combalia@clinic.cat.
authors.forename: A
authors.initials: A
authors.lastname: Combalia
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Hospital Clínic and Department of Human Anatomy and Embryology - institut d'Investigació August Pi i Sunyer IDIBAPS, Faculty of Medicine, University of Barcelona, Carrer Villarroel 170, 08036 Barcelona, Spain. Electronic address: acarreno@clinic.cat.
authors.forename: A
authors.initials: A
authors.lastname: Carreño
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Hospital Clínic and Department of Human Anatomy and Embryology - institut d'Investigació August Pi i Sunyer IDIBAPS, Faculty of Medicine, University of Barcelona, Carrer Villarroel 170, 08036 Barcelona, Spain. Electronic address: arandes@clinic.ub.es.
authors.forename: J M
authors.initials: JM
authors.lastname: Arandes
mesh_terms: D000328:Adult; D001859:Bone Neoplasms / Q000556:secondary*; D002277:Carcinoma / Q000473:pathology / Q000556:secondary*; D005260:Female; D050276:Hand Bones / Q000473:pathology*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000556:secondary*; D008875:Middle Aged
keywords: Acrometastasis; Acrométastases; Carcinoma; Carcinome; Doigt; Finger; Hand; Main