Osseous metastatic disease to the hands and feet

Jad M. El Abiad, Keith Aziz, Adam Levin, Edward M. McCarthy, Carol D Morris

Research output: Contribution to journalArticle

Abstract

Osseous metastases to the hands and feet (acrometastases) are exceedingly rare. Historically, the most common primary cancer observed has been lung carcinoma, treated either nonoperatively or with amputation. The aim of this study was to describe the clinical characteristics associated with acrometastases. This was a retrospective review of 28 patients with histologically proven osseous metastatic disease to the hands and feet. Variables recorded included primary cancer histology, age at diagnosis of primary and acrometastases, location of acrometastases, burden of disease, treatment, and age at death. Kaplan-Meier curves were used to estimate survival, and log-rank tests were used for comparison. The median age at acrometastases diagnosis was 61.5 years, and the most common associated primary cancer was lung carcinoma (n=9). Sixteen patients had acrometastases to the foot, and 12 had acrometastases to the hand. In the foot, most acrometastases were located in the tarsal bones (n=11), followed by the metatarsals (n=4) and the phalanges (n=3). In the hand, most were in the metacarpals and the phalanges (n=6 each), and 2 were in the carpals. The most common treatment was resection or curettage only (n=7). The median duration of survival after acrometastases diagnosis was 9.7 months. Despite advances in cancer treatment and shifting patterns of metastatic disease, there has been little change in the distribution of primary malignancies responsible for acrometastases, with lung carcinoma remaining the most common. Ablative procedures are rarely required, with limb-salvage interventions predominating.

Original languageEnglish (US)
Pages (from-to)E197-E201
JournalOrthopedics
Volume42
Issue number2
DOIs
StatePublished - Mar 1 2019

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Foot
Hand
Carcinoma
Neoplasms
Tarsal Bones
Lung
Limb Salvage
Metacarpal Bones
Metatarsal Bones
Survival
Curettage
Wrist
Amputation
Lung Neoplasms
Histology
Therapeutics
Neoplasm Metastasis

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Osseous metastatic disease to the hands and feet. / El Abiad, Jad M.; Aziz, Keith; Levin, Adam; McCarthy, Edward M.; Morris, Carol D.

In: Orthopedics, Vol. 42, No. 2, 01.03.2019, p. E197-E201.

Research output: Contribution to journalArticle

El Abiad, Jad M. ; Aziz, Keith ; Levin, Adam ; McCarthy, Edward M. ; Morris, Carol D. / Osseous metastatic disease to the hands and feet. In: Orthopedics. 2019 ; Vol. 42, No. 2. pp. E197-E201.
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