Supportive Care in Cancer

, Volume 12, Issue 3, pp 202–204 | Cite as

Palliative surgery of acrometastases from lung cancer: a case report

  • Tiziana Campa
  • Elena Fagnoni
  • Carla RipamontiEmail author
Short Communication


A clinical case of a woman with lung cancer and a very painful bone metastases of the phalangette of the 4th finger of the right hand (acrometastases) is described. Palliative radiation on the 4th finger was not indicated due to almost complete bone destruction. Both patient and daughter refused administration of strong opioids, such as morphine, for pain management, due to fear of addiction and of opioid-related adverse effects. Phalangectomy, with palliative intent, was performed under local anaesthesia, in day surgery, resulting in complete pain relief.


Acrometastases Lung cancer Pain Palliative surgery Opiodphobia 


  1. 1.
    Abrahams TG (1995) Occult malignancy presenting as metastatic disease to the hand and wrist. Skeletal Radiol 24:135–137PubMedGoogle Scholar
  2. 2.
    Baran R, Tosti A (1994) Metastatic carcinoma to the terminal phalanx of big toe: report of two cases and review of the literature. J Am Acad Dermatol 31:259–263PubMedGoogle Scholar
  3. 3.
    Forbes JF (1988) Palliative surgery in cancer patients: principles and potential of palliative surgery in patient with advanced cancer. Recent Result Cancer Res 108:134–142Google Scholar
  4. 4.
    Healey JH, Turnbull ADM, Miedema B et al (1986) Acrometastases: a study of twenty-nine patients with osseous involvement of the hands and feet. J Bone Joint Surg Am 68:743–746Google Scholar
  5. 5.
    Krouse RS, Nelson RA, Farrel BR, Grube B et al (2001) Surgical palliation at a Cancer Center. Arch Surg 136:773–778CrossRefPubMedGoogle Scholar
  6. 6.
    Merimsky O, Kollender Y, Inbar M, Lev-Chelouche D, Gutman M, Issakov J et al (2001) Is forequarter amputation justified for palliation of intractable cancer symptoms. Oncology 60:55–59CrossRefPubMedGoogle Scholar
  7. 7.
    Milch RA, Dunn GP (1997) The surgeon’s role in palliative care. Bull Am Coll Surg 82:14–17Google Scholar
  8. 8.
    Miner TJ, Jaques DP, Tavaf-Motamen H, Shriver CD (1999) Decision making on surgical palliation based on patient outcome data. Am J Surg 177:150–154CrossRefPubMedGoogle Scholar
  9. 9.
    Ryu JS, Cho JW, Moon TH, Lee HL, Han HS, Choi GS (2000) Squamous cell lung cancer with solitary subungual metastasis. Yonsey Med J 41:666–668Google Scholar
  10. 10.
    Skarin A (1999) Diagnosis in oncology. J Clin Onc 17:2995–3001Google Scholar
  11. 11.
    Wu KK (1995) Bronchogenic carcinoma with metastases to the foot: A report of two cases. J Foot Ankle Surg 34:322–326PubMedGoogle Scholar
  12. 12.
    Zenz M, Willweber-Strumpf A (1993) Opiophobia and cancer pain in Europe. Lancet 341:1075–1076CrossRefPubMedGoogle Scholar
  13. 13.
    Zylicz Z (1993) Opiophobia and cancer pain. Lancet 341:1473–1474CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Rehabilitation and Palliative Care Operative UnitNational Cancer Institute of MilanMilanItaly

Personalised recommendations