Rare Cancer Complication Leads to Bone Replacement in Patient

A 55-year-old man from Australia diagnosed with metastatic squamous-cell lung cancer faced a rare and severe complication: his bones had been replaced by cancerous tumors. Initially, he attributed the swelling of his right middle finger and right big toe to harmless causes. However, medical evaluations revealed the alarming extent of his condition, with the cancer aggressively spreading throughout his body.

This particular form of lung cancer arises from the flat, thin cells lining the airways and accounts for approximately 25 percent of all lung cancer cases, amounting to about 58,000 diagnoses annually. Six weeks after experiencing painful swelling, the man sought treatment at his local hospital. He presented with club-like deformities in his digits, characterized by red, swollen tips that were sensitive to touch. An ulcer had also developed near the nail of his affected toe, which had turned a bright yellow.

Medical imaging, including radiographs, showed destructive lytic lesions in the affected hand and foot, indicating that the bone tissue had been substantially compromised. In this case, the empty spaces in his bones had been “completely replaced” by tumors. Doctors diagnosed him with acrometastasis, a rare condition where cancer spreads to the bones of the hands and feet, below the elbows and knees.

Acrometastasis constitutes about 0.1 percent of all cancer cases that have metastasized to the bones. Most often, it is observed in patients already diagnosed with cancer, but it can also serve as an initial indicator of undiagnosed cancers in various parts of the body, such as the lungs or gastrointestinal tract. Studies suggest this condition is significantly more prevalent in men, correlating with the higher incidence of lung cancer in this demographic.

The rarity of acrometastasis can be attributed to several factors. Cancer cells typically migrate to areas rich in bone marrow, such as the long bones in the arms and legs. Since the bones in fingers and toes contain considerably less marrow, they are less likely to be affected. Additionally, the reduced blood flow to extremities makes it challenging for cancer cells to reach the fingertips and toes.

Unfortunately, acrometastasis carries a poor prognosis, often associated with advanced-stage cancer. Patients diagnosed with this condition typically have a survival expectancy of less than six months, with treatment primarily focused on pain management rather than cure.

In this man’s case, doctors initiated palliative radiotherapy aimed at alleviating pain stemming from the bone metastases. Tragically, he passed away just three weeks later due to refractory hypercalcemia, a condition characterized by dangerously elevated calcium levels in the blood—a common complication among cancer patients. This case highlights the severe impacts of metastatic cancer and underscores the complexities involved in its management.