The digital pulp as a presenting site of metastatic esophageal carcinoma

An unusual skin lesion may be a primary skin cancer or a sign of internal malignancy. Metastatic lesions to the hand are rare. The authors describe a patient who presented with a nodule of the digital pulp. Workup, including X-ray films and biopsy, revealed a metastatic squamous cell carcinoma invading the distal phalanx. The primary site of the tumor was the esophagus. To the best of their knowledge, this is the second case described in the literature of a metastatic carcinoma of the esophagus presenting as a lesion of the digital pulp.