A 55-year-old man with advanced lung cancer developed an unusual swelling in his right middle finger and big toe, which quickly took on a clublike appearance. According to a report in the New England Journal of Medicine, scans revealed that cancer had "completely replaced" the bones at the tips of both digits with destructive lesions—a rare phenomenon known as acrometastasis, per Live Science.
Acrometastasis, when cancer spreads to bones in the fingers or toes, is highly uncommon, representing only about 0.1% of bone metastases. It's most often linked to cancers in the lung, gastrointestinal tract, and genitourinary system and tends to be seen in late-stage disease, more frequently in men than in women. The bones of the fingers and toes are rarely targeted by metastatic cancer, possibly because they lack both the marrow and blood supply found in larger bones.
Physically, the affected digits in this case (the NEJM has photos here) were red, swollen, firm, and tender, with the toe developing an ulcer near the nail. While such symptoms can mimic more common conditions such as gout or bone infections, radiographs can reveal the underlying cause. Because acrometastases are usually a sign of advanced cancer, survival is poor—often measured in months.
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Treatments typically focus on pain relief and preserving function rather than on a cure. The patient here received palliative radiotherapy but died three weeks later due to complications from refractory hypercalcemia, a marked rise in blood calcium sometimes triggered by cancer.
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