The hand in metastatic disease and acral manifestations of paraneoplastic syndromes

Extensive Cutaneous Metastatic Breast Carcinoma of the Hand and Upper Extremity: A Case Report

“…12 The median survival for patients with metastatic tumors to the hand is approximately 6 months. 5,6 Forequarter amputation for palliative treatment of axillary chest wall cutaneous metastasis of breast carcinoma has also been reported by Wittig et al, 4 Pressman, 13 and Holleb and Lucas. 3 Goodman et al 14 reported a 35-month disease-free follow-up period in a 56-year-old woman with recurrent breast carcinoma to the cutaneous tissues of the axillary region who was treated with forequarter amputation.…”

“…Cutaneous metastatic breast carcinoma that has spread to the axillary region requiring palliative treatment has been reported by several researchers, 3,4 and metastatic involvement of the bones of the hand and wrist from breast cancer is well recognized. 5 We report a case of extensive cutaneous metastatic breast carcinoma of the upper limb with distant involvement of the hand.…”

Improved Survival for Sarcomas of the Wrist and Hand

“…2 In addition it has been estimated that 0.1% of skeletal metastases from carcinomas involve the bones of the hand and that 16% to 25% of these lesions represent the first sign of an underlying malignancy. [3][4][5][6] It generally has been believed that benign tumors occurring in the hand and wrist behave more aggressively than those arising in other musculoskeletal sites [7][8][9][10][11][12][13][14][15] whereas malignancies seem to behave less aggressively (with the exception of rhabdomyosarcoma 16,17 ). Favorable outcomes for this group of tumors have been associated with attainment of wide margins at the time of surgical resection, 18 -23 prompt institution of multimodal therapy, 22,24 -28 tumor size smaller than 5 cm, and Musculoskeletal Tumor Society stage I or II lesions.…”

Pain and Deformity of the Index Finger in a 41-year-old Woman

“…Metastatic disease is extremely rare in such acral locations (0.1% of all skeletal metastatic lesions), and when it does occur, it is most commonly lung or renal carcinoma [7]. This diagnosis is unlikely given the insidious presentation of this lesion and the absence of systemic disease, and histologic examination failed to show such cells.…”