A 55-year-old man\u2019s swollen toes and fingers turned out to have a much stranger explanation than expected. In a recent case report, the man\u2019s doctors detailed how some of his bones were \u201ccompletely replaced\u201d by metastatic tumors.<\/p>\n
Doctors in Australia described<\/a> the case earlier this month in the New England Journal of Medicine. The man visited the hospital after weeks of having pain and swelling in one finger and one toe. They soon discovered the symptoms were an unusual complication of the man\u2019s earlier diagnosed metastatic squamous-cell lung cancer. Tragically, he soon died after.<\/p>\n<\/p>\n The man, as it turned out, had acrometastases\u2014or cancers that had spread beyond his lungs to the bones past his elbows and knees. Acrometastases are incredibly rare, only estimated<\/a> to occur in 0.1% of cases where cancer spreads to the bones. Though they\u2019re sometimes the first sign of a hidden late-stage cancer, they\u2019re more often preceded by other noticeable symptoms, as in this case. The condition is typically caused by cancers of the lung, gastrointestinal tract, and urinary tract; it\u2019s also more common in men.<\/p>\n According to the report, the man had experienced six weeks of painful swelling in his right middle finger and right big toe, along with an open wound under the toe\u2019s fingernail. The swollen appendages were also firm and tender to touch. Acrometastases can superficially resemble gout or osteomyelitis, the report authors noted. But X-rays easily revealed the cause behind the man\u2019s symptoms: cancerous lesions that had \u201ccompletely replaced\u201d the outermost bones of his finger and toe.<\/p>\n<\/p>\n Images of the man\u2019s finger and toe can be seen here<\/a> in an X post from the NEJM, and also embedded below.<\/p>\n 55-year-old man with metastatic squamous-cell lung cancer presented with a 6-week history of pain and swelling of the right great toe and the tip of the right middle finger. <\/p>\n Read the full case details in the Images in Clinical Medicine article \u201cAcrometastases,\u201d from @petermaccc<\/a>\u2026 pic.twitter.com\/SPwSuKVZHV<\/a><\/p>\n \u2014 NEJM (@NEJM) July 17, 2025<\/a><\/p>\n<\/blockquote>\n Because acrometastases are usually the result of highly advanced cancer, people\u2019s odds of survival once they develop it are already low. People are typically expected to live less than six months after diagnosis. In this case, the doctors opted to treat the patient with palliative radiotherapy, which is intended to alleviate the symptoms of cancer rather than to eradicate it. The man died about three weeks later from refractory hypercalcemia<\/a>, or dangerously high levels of calcium in the blood that don\u2019t respond to standard treatment. This condition is often a complication of cancer as well.<\/p>\n \n