A 55-year-old man’s swollen toes and fingers turned out to have a a lot stranger rationalization than anticipated. In a latest case report, the person’s medical doctors detailed how a few of his bones had been “fully changed” by metastatic tumors.
Medical doctors in Australia described the case earlier this month within the New England Journal of Medication. The person visited the hospital after weeks of getting ache and swelling in a single finger and one toe. They quickly found the signs had been an uncommon complication of the person’s earlier identified metastatic squamous-cell lung most cancers. Tragically, he quickly died after.
The person, because it turned out, had acrometastases—or cancers that had unfold past his lungs to the bones previous his elbows and knees. Acrometastases are extremely uncommon, solely estimated to happen in 0.1% of circumstances the place most cancers spreads to the bones. Although they’re generally the primary signal of a hidden late-stage most cancers, they’re extra typically preceded by different noticeable signs, as on this case. The situation is often brought on by cancers of the lung, gastrointestinal tract, and urinary tract; it’s additionally extra widespread in males.
In line with the report, the person had skilled six weeks of painful swelling in his proper center finger and proper massive toe, together with an open wound beneath the toe’s fingernail. The swollen appendages had been additionally agency and tender to the touch. Acrometastases can superficially resemble gout or osteomyelitis, the report authors famous. However X-rays simply revealed the trigger behind the person’s signs: cancerous lesions that had “fully changed” the outermost bones of his finger and toe.
Pictures of the person’s finger and toe may be seen here in an X publish from the NEJM, and likewise embedded beneath.
55-year-old man with metastatic squamous-cell lung most cancers introduced with a 6-week historical past of ache and swelling of the fitting nice toe and the tip of the fitting center finger.
Learn the total case particulars within the Pictures in Scientific Medication article “Acrometastases,” from @petermaccc… pic.twitter.com/SPwSuKVZHV
— NEJM (@NEJM) July 17, 2025
As a result of acrometastases are normally the results of extremely superior most cancers, folks’s odds of survival as soon as they develop it are already low. On common, persons are anticipated to reside lower than six months after prognosis. On this case, the medical doctors opted to deal with the affected person with palliative radiotherapy, which is meant to alleviate the signs of most cancers reasonably than to eradicate it. The person died about three weeks later from refractory hypercalcemia, or dangerously excessive ranges of calcium within the blood that don’t reply to plain remedy. This situation is usually a complication of most cancers as effectively.
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