Acrometastases to the Hand and Wrist: A Series of 9 Cases and Review of the Literature

Abstract

Introduction Acrometastases are extremely rare in the hand, with a prevalence of around 0.1% according to the literature. They are normally associated with advanced tumor stages, especially in lung cancer. The present article shows the experience of our center in the management and treatment of these pathologies. Materials and Methods We report a series of 9 cases treated between 1992 and 2020 in the hand and wrist. Data regarding the primary tumor, the target organ, and survival are analyzed. A review of the cases of acrometastasis reported in the literature is also carried out, emphasizing in how many of then the acral lesion was the first sign of an unknown tumor. Results Acrometastases predominantly affect male patients aged around 60 years, and the primary tumor that is the cause in most cases is lung cancer, with a very low survival rate after the diagnosis (of approximately 8 months). Discussion and Conclusions In cases of acral lesion of non-traumatic origin, acrometastases should be considered, especially in patients who have a known primary tumor. In the present series, there were three cases in which the acrometastases were the first sign of a tumor in the patient, and in one of them it was initially treated as whitlow. In the literature, in approximately 50% of the cases, acrometastases are the first sign of the presence of a tumor. Once diagnosed, multidisciplinary medicosurgical treatment is essential to improve the patient's function and pain as much as possible.

Keywords

• acrometastases
• hand
• acral injury
• finger
• bone metastases