We report the case of a 43-year-old woman, light smoker, who consulted due to painful swelling on the fourth finger of her left hand, with no other symptoms (Fig. 1). A radiograph showed a lytic lesion on the middle phalanx of the fourth finger (Fig. 1B). A chest X-ray was performed, revealing remarkable bilateral nodular involvement, with a tumor-like appearance (Fig. 1C). A dominant mass in the upper right lobe and innumerable bilateral small nodules were confirmed by chest computed tomography (Fig. 1D).
(A) Painful swelling (arrow) affecting the intermediate phalanx of the fourth finger of the left hand. (B) Radiograph of the left hand showing a lytic lesion in the intermediate phalanx of the fourth finger (asterisk) accompanied by increased volume of soft tissue (arrows). (C) Chest radiograph showing remarkable bilateral nodular involvement. (D) Axial CT image (lung window) showing a dominant spiculated mass in the right lung (asterisk), along with multiple bilateral small lung nodules.
Acrometastasis accounts for less than 0.1% of bone metastases in patients with solid tumors, and the most common primary tumor is lung carcinoma.1 Most cases occur in elderly men already diagnosed with a primary tumor, and mean survival after detection is around 6 months.2 They are more common in the right hand, and the bones most frequently affected are the distal phalanges, followed by the metacarpal, proximal and intermediate phalanges. We believe our case is of interest because it illustrates a highly atypical form of presentation of lung cancer in a young woman who had no other symptoms at the time of diagnosis of acrometastasis.
Please cite this article as: Gorospe Sarasúa L, Mezquita Pérez L, Pacios Blanco RE. Acrometástasis como presentación inicial de un adenocarcinoma de pulmón en una mujer joven. Arch Bronconeumol. 2016;52:482–483.
