Metastatic phalangeal osteolysis as an initial presentation of carcinoma colon

Metastatic malignancies of the hand are rare and usually develop from lung, breast, or kidney tumors. Metastases from tumors and sarcomas of the gastrointestinal system are even more uncommon. The authors report a case of differentiated adenocarcinoma of the colon in a 76-year-old man who presented with distal phalangeal metastasis and osteolysis in the form of a painful swelling at the tip of the right little finger of 6 months duration. Computed tomography of the abdomen and colonoscopy revealed a mass in the transverse colon. Diagnosis was confirmed by biopsy. Treatment was given with palliative local radiation and systemic chemotherapy. After 4 weeks of chemotherapy, the patient discontinued treatment and eventually succumbed to the disease.