Metastatic gastric adenocarcinoma mimicking osteomyelitis of second toe

Recurrence of gastric carcinoma most frequently involves abdominal distension and usually occurs with in 5 years of primary surgery. Recurrence more than 8 years after surgery is extremely rare and bony metastasis occurs only in 0-17% cases of gastric carcinoma. We present a case of metastasis to the second toe which occurred 12 years after the initial surgery. The case highlights the importance of high index of suspicion of pedal metastasis in patients presenting with swelling or bony tenderness with history of carcinoma.