Next Article in Journal
Treating Recurrent Cases of Squamous Cell Carcinoma with Radiotherapy
Previous Article in Journal
Quality of Life in Brain Metastases Radiation Trials: A Literature Review
Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on as a courtesy and upon agreement with Multimed Inc..
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:

Two Cases of Acrometastasis to the Hands and Review of the Literature

Rapid Response Radiotherapy Program, Department of Radiation Oncology, Toronto–Sunnybrook Regional Cancer Centre, Toronto, ON, Canada
Department of Pathology, Toronto–Sunnybrook Regional Cancer Centre, Toronto, ON, Canada
Department of Radiology, Toronto–Sunnybrook Regional Cancer Centre, Toronto, ON, Canada
Department of Orthopedic Surgery, Toronto–Sunnybrook Regional Cancer Centre, Toronto, ON, Canada
Edward Chow, Department of Radiation Oncology, University of Toronto, Toronto–Sunnybrook Regional Cancer Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
Author to whom correspondence should be addressed.
Curr. Oncol. 2008, 15(5), 51-58;
Received: 7 July 2008 / Revised: 5 August 2008 / Accepted: 6 September 2008 / Published: 1 October 2008


This paper reports two cases of acrometastasis to the hands. The first case involved a 78-year-old woman with a permeative osteolytic lesion in her proximal second metacarpal. A biopsy of this lesion suggested a diagnosis of non-small-cell lung carcinoma with secondary osseous metastasis. This was the first presentation of the woman’s primary diagnosis. A single 8-Gy fraction of palliative radiotherapy was delivered to the patient’s left hand. The treatment proved successful: the woman soon experienced pain relief and regained the use of her hand. The second case involved a 69- year-old woman with extensive lytic destruction involving the proximal two thirds of her third metacarpal. This patient had been diagnosed with carcinoma of the breast in 1990. She also received a single 8-Gy fraction of radiation, which improved both her pain and her hand mobility. An extensive review of the literature uncovered 257 previously reported cases of acrometastasis. Articles were analyzed based on age and sex of the patient, site of the primary carcinoma, metastatic locations within the hand and affected appendage or appendages, the treatment given, and the patient’s length of survival. Men were almost twice as likely to experience acrometastasis as women, and the median age of the patients overall was 58 years (range: 18 months–91 years). Lung, kidney, and breast carcinoma were the three most prevalent primary diagnoses reported in the literature. Cancers of the colon, stomach, liver, prostate, and rectum affected the remainder of the population. Overall, the right hand was more often host to the metastatic lesions. In addition, almost 10% of the patients experienced lesions in both hands. The third finger was the digit most affected by osseous metastases reported in the literature. Lesions of the thumb, fourth finger, second finger, and fifth finger were less commonly reported. The region of the digit most often affected within the patient population was the distal phalanx. The metacarpal bones, proximal phalanges, and middle phalanges comprised the remainder of the four most frequent acrometastatic sites. In the literature, single lesions were more prevalent than multiple bony lesions. Based on the reported cases, amputation appeared to be the preferred method of treatment. Radiation, excision, and systemic therapy were the next most frequently used treatments. Patient survival was not well documented within the literature. However, the median survival of patients in the reported cases was 6 months. Thus, our review suggested that a diagnosis of hand metastasis is an indication of poor prognosis. This report serves to emphasize the importance of properly diagnosing acrometastases. Identifying and effectively treating these metastases in a timely manner can lead to a dramatic improvement in a patient’s quality of life.
Keywords: Acrometastasis; hand metastasis; bone metastases Acrometastasis; hand metastasis; bone metastases

Share and Cite

MDPI and ACS Style

Flynn, C.J.; Danjoux, C.; Wong, J.; Christakis, M.; Rubenstein, J.; Yee, A.; Yip, D.; Chow, E. Two Cases of Acrometastasis to the Hands and Review of the Literature. Curr. Oncol. 2008, 15, 51-58.

AMA Style

Flynn CJ, Danjoux C, Wong J, Christakis M, Rubenstein J, Yee A, Yip D, Chow E. Two Cases of Acrometastasis to the Hands and Review of the Literature. Current Oncology. 2008; 15(5):51-58.

Chicago/Turabian Style

Flynn, C. J., C. Danjoux, J. Wong, M. Christakis, J. Rubenstein, A. Yee, D. Yip, and E. Chow. 2008. "Two Cases of Acrometastasis to the Hands and Review of the Literature" Current Oncology 15, no. 5: 51-58.

Article Metrics

Back to TopTop