Abstract：
UNASSIGNED: Hand metastases are notably rare, comprising around 0.1% of all metastatic diseases, mainly originating from lung cancer, which is responsible for 30-40% of such cases. This report highlights a rare occurrence of distal phalangeal metastasis in a patient with Lynch syndrome, underscoring the diagnostic challenges associated with hand metastases.
METHODS: A 70-year-old male diagnosed with Lynch syndrome 35 years ago, following colon adenocarcinoma, presented with severe inflammatory lesions on his right index finger. Patient had previous liver segmentectomies to remove metastatic lesions and had multiple cutaneous squamous cell carcinomas in various regions. Recent diagnostics, including a chest CT, identified a thoracic mass suggestive of squamous cell lung carcinoma. Histopathological analysis confirmed the metastasis of lung cancer to the index finger, necessitating a transphalangeal amputation.
UNASSIGNED: Hand metastases are extremely infrequent, often mimicking other conditions and requiring a high index of suspicion for accurate diagnosis. This case reinforces the lung as a frequent origin of hand metastases and the significance of elevated EGFR expression in facilitating metastatic spread.
CONCLUSIONS: The rarity of hand metastasis in patients with genetic predispositions like Lynch syndrome calls for heightened vigilance and an integrated management approach. It highlights the critical role of histopathology in diagnosis and the need to consider genetic factors in treatment planning. Further research is encouraged to understand the mechanisms enabling certain cancers to metastasize to the hand and the role of genetic conditions in these processes.
METHODS: A 70-year-old male diagnosed with Lynch syndrome 35 years ago, following colon adenocarcinoma, presented with severe inflammatory lesions on his right index finger. Patient had previous liver segmentectomies to remove metastatic lesions and had multiple cutaneous squamous cell carcinomas in various regions. Recent diagnostics, including a chest CT, identified a thoracic mass suggestive of squamous cell lung carcinoma. Histopathological analysis confirmed the metastasis of lung cancer to the index finger, necessitating a transphalangeal amputation.
UNASSIGNED: Hand metastases are extremely infrequent, often mimicking other conditions and requiring a high index of suspicion for accurate diagnosis. This case reinforces the lung as a frequent origin of hand metastases and the significance of elevated EGFR expression in facilitating metastatic spread.
CONCLUSIONS: The rarity of hand metastasis in patients with genetic predispositions like Lynch syndrome calls for heightened vigilance and an integrated management approach. It highlights the critical role of histopathology in diagnosis and the need to consider genetic factors in treatment planning. Further research is encouraged to understand the mechanisms enabling certain cancers to metastasize to the hand and the role of genetic conditions in these processes.
摘要：
■手部转移非常罕见，占所有转移性疾病的0.1%左右，主要来源于肺癌,占此类案件的30-40%。该报告强调了Lynch综合征患者中很少发生远端指骨转移，强调与手部转移相关的诊断挑战。
方法：35年前一名70岁男性被诊断患有林奇综合征，结肠腺癌之后，右手食指上有严重的炎性病变.患者先前进行了肝段切除术以去除转移性病变，并且在各个区域患有多发性皮肤鳞状细胞癌。最近的诊断，包括胸部CT,发现胸部肿块提示鳞状细胞肺癌。组织病理学分析证实肺癌转移到食指，需要经口截肢。
■手部转移极为罕见，经常模仿其他情况，需要高度怀疑才能准确诊断。该病例加强了肺作为手部转移的常见起源以及EGFR表达升高在促进转移扩散中的重要性。
结论：在具有Lynch综合征等遗传易感性的患者中，手部转移的罕见性需要提高警惕和综合管理方法。它强调了组织病理学在诊断中的关键作用以及在治疗计划中考虑遗传因素的必要性。鼓励进一步研究以了解使某些癌症转移到手的机制以及遗传条件在这些过程中的作用。
方法：35年前一名70岁男性被诊断患有林奇综合征，结肠腺癌之后，右手食指上有严重的炎性病变.患者先前进行了肝段切除术以去除转移性病变，并且在各个区域患有多发性皮肤鳞状细胞癌。最近的诊断，包括胸部CT,发现胸部肿块提示鳞状细胞肺癌。组织病理学分析证实肺癌转移到食指，需要经口截肢。
■手部转移极为罕见，经常模仿其他情况，需要高度怀疑才能准确诊断。该病例加强了肺作为手部转移的常见起源以及EGFR表达升高在促进转移扩散中的重要性。
结论：在具有Lynch综合征等遗传易感性的患者中，手部转移的罕见性需要提高警惕和综合管理方法。它强调了组织病理学在诊断中的关键作用以及在治疗计划中考虑遗传因素的必要性。鼓励进一步研究以了解使某些癌症转移到手的机制以及遗传条件在这些过程中的作用。
