Osseous metastases in the hand. A general review of three cases.

Osseous metastases in the hand are rare. The authors report 3 cases, bringing the total number of reported cases up to 106. They affect mainly men; their clinical features are local swelling and pain frequently ascribed to a trauma. The diagnosis is often mistaken, many patients being initially treated for a distal felon. Distal phalanx is the main involved area, with irregular osteolysis and cortical destruction. The etiology is quite different from that of metastases to other bones: bronchopulmonary cancer is by far the most frequent with 46% of cases, followed by breast cancer (15%). Other types of cancer are much less frequently involved. The evolution is sombre; average life expectancy is 3 1/2 months. Treatment may involve, as needed, distal digital amputation on antalgic radiotherapy.