Bronchogenic carcinoma metastasis to first metacarpal bone: A rare case report

Metastasis accounts for the majority of malignant bone tumors in adults. The commonly involved bones are pelvis, spine and proximal long bone. Metastasis below elbow and knee joint is rare. Metastasis to the hand is very rare, when they occur the commonest sites are distal phalanges. Lung cancer is the commonest primary to metastasize to the hand. Here we present a 51-year-old male known lung cancer (adenocarcinoma of the lung) patient for whom lobectomy was done and put on adjuvant chemotherapy latter presented with long standing left thumb pain and swelling, initially treated with antipain with a diagnostic impression of tenosynovitis. Ultrasound guided core needle biopsy was taken and metastatic adenocarcinoma infiltration confirmed. Hand metastasis is usually mistaken for inflammatory or infectious conditions, so what we wanted to highlight in this case report is although hand metastasis is very rare it should be considered in patients with long standing pain and swelling especially if there is any primary tumor even if its remote. In few cases it can also be an initial presentation.