Department of Orthopedics, The Fourth Hospital of Hebei Medical University, 12 Health Road, Shijiazhuang, Hebei, 050011, People's Republic of China.
Department of Breast Surgery, The Fourth Hospital of Hebei Medical University, 12 Health Road, Shijiazhuang, Hebei, 050011, People's Republic of China.
BMC Urol. 2020 Feb 24;20(1):19. doi: 10.1186/s12894-020-00588-4.
Bone metastasis is known to occur in some patients with cancer, usually in the spine, pelvis or ribs, and less than 0.01% of patients have metastases in the foot bone, so metatarsal metastasis is quite rare. The initial symptoms of osseous metastases are swelling, pain, or both.
We report a 68-year-old man with solitary metatarsal metastasis 26 months after a diagnosis of renal clear cell carcinoma. The patient suffered intermittent swelling of his right foot and pain for one year due to trauma and was not treated. The doctor attributed the symptoms to trauma, administering massage therapy and a plaster cast to the patient at the local clinic. After reviewing the medical records, we found that this patient had a history of clear cell renal cell carcinoma. The patient underwent radiological examination and open biopsy of the first metatarsal bone of the right foot. These findings confirmed that the patient had a metatarsal metastasis from clear cell renal cell carcinoma. The patient subsequently underwent right foot amputation. No local recurrence or distant metastasis was found after a 6-month follow-up.
Clinicians should be aware of a history of renal cell carcinoma (RCC) and fully understand the patient's past medical history. When treating patients with clear cell renal cell carcinoma who have unresolving bony pain or swelling, clinicians should always keep in mind the possibility of bone metastasis of RCC.
众所周知，癌症患者会发生骨转移，通常发生在脊柱、骨盆或肋骨，不到 0.01%的患者足部骨骼有转移，因此跖骨转移非常罕见。骨转移的初始症状为肿胀、疼痛或两者兼有。
我们报告了 1 例 68 岁男性患者，在诊断为肾透明细胞癌 26 个月后出现单一跖骨转移。由于外伤，该患者的右脚出现间歇性肿胀和疼痛 1 年，未接受治疗。医生将症状归因于外伤，在当地诊所对患者进行了按摩治疗和石膏固定。在查阅病历后，我们发现该患者有肾透明细胞癌病史。患者接受了右足第一跖骨的影像学检查和开放性活检。这些发现证实患者患有透明细胞肾细胞癌跖骨转移。随后患者接受了右足截肢术。在 6 个月的随访中，未发现局部复发或远处转移。
临床医生应了解肾细胞癌（RCC）病史，并充分了解患者的既往病史。当治疗患有不缓解的骨痛或肿胀的透明细胞肾细胞癌患者时，临床医生应始终牢记 RCC 骨转移的可能性。
