A case of lung squamous cell carcinoma presenting as acrometastasis to the finger skin
Yasuyuki Ikezawaa Hidenori Mizugakia Hiromi Okadab Satoshi Oizumia Yoshihiro Matsunob Masaharu Nishimuraa
aFirst Department of Medicine, Hokkaido University Hospital
bDepartment of Surgical Pathology, Hokkaido University Hospital
In lung cancer patients, metastasis to soft tissues, including muscle, subcutaneous tissue, and skin, is rare. Metastatic presentation on the hand from occult malignancy can be very deceptive, often mimicking infection, gout, arthritis, and other ailments. Therefore, these cases unfortunately lead to a low index of suspicion of malignancy and may result in a delay in diagnosis. A-79-year-old man was referred to our department. Investigation resulted in a diagnosis of lung squamous cell carcinoma at stage IIIB, and he received treatment with vinorelbine. Although the effect of treatment was stable disease, his condition was deteriorating, and he planned to receive palliative care. In 2015, the nail matrix of the patient's left middle finger had abrasio cutis and became hemorrhagic. Because of the difficulty in achieving hemostasis, he was referred to the plastic surgery department. The tumor quickly enlarged, and its bleeding was difficult to stop. The plastic surgeon resected it at the middle phalanx of the left middle finger. Microscopic findings of finger lesions were similar to those of bronchial lesions, and we diagnosed metastasis to the skin of the finger. When examining swelling of the fingers in patients with malignancy, physicians need to be mindful of the possibility of metastasis.
Acrometastasis to the finger Lung cancer Squamous cell carcinoma
Received 2 Nov 2015 / Accepted 29 Mar 2016
AJRS, 5(4): 189-193, 2016