[Digital ischemia of a patient with undifferentiated large cell lung cancer]

A Raynaud's phenomenon with acral ischemia till necrosis is a rare form of a paraneoplasia. We report about a woman with a metastatic lung cancer, who was admitted because of pain in her left hand with necrosis of the fingertips and of the fifth right toe. We started a treatment with the intravenous vasodilator Iloprost, but the necroses progressed to gangrene. The course of a paraneoplastic syndrome is often determined by the underlying malignoma and if the antineoplastic treatment is ineffective, the chances to treat the paraneoplasia may be limited.