Kumar Ashok
Department of Radiation Oncology, Army Hospital R & R, Delhi, India.
BMJ Case Rep. 2019 Aug 10;12(8):e229390. doi: 10.1136/bcr-2019-229390.
Acrometastasis caused by malignancy is a very rare phenomenon, and gastric malignancy metastasising to the hands is an even rarer entity. It accounts for only 0.1% of all metastatic osseous involvement, and may be a late manifestation of malignancy or may even be a presenting symptom. It is generally seen with lung primary, followed by kidney and breast, and less frequently with colon, liver, prostate, rectum and stomach primaries. The terminal phalanges are the most common sites of metastases, followed by the metacarpals and the proximal phalanges. We present a case of stomach carcinoma with metastases to the liver and adrenals which was managed with three lines of chemotherapy. He was lost to follow-up and reported after 1 year with swelling over his left hand, which was managed with palliative radiation to the hand in view of severe pain, followed by chemotherapy.
恶性肿瘤引起的肢端转移是一种非常罕见的现象，而胃癌转移至手部更是罕见。它仅占所有骨转移的0.1%，可能是恶性肿瘤的晚期表现，甚至可能是首发症状。通常在原发性肺癌之后出现，其次是肾癌和乳腺癌，较少见于原发性结肠癌、肝癌、前列腺癌、直肠癌和胃癌。末节指骨是最常见的转移部位，其次是掌骨和近节指骨。我们报告一例胃癌肝转移和肾上腺转移患者，接受了三线化疗。他失访1年后因左手肿胀前来就诊，鉴于疼痛剧烈，对手部进行了姑息性放疗，随后继续化疗。
