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Metastasis02:30

Metastasis

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Metastasis is the spread of cancer cells from the original site to distant locations in the body. Cancer cells can spread via blood vessels (hematogenous) as well as lymph vessels in the body.
Epithelial-to-Mesenchymal Transition
The epithelial-to-mesenchymal transition or EMT is a developmental process commonly observed in wound healing, embryogenesis, and cancer metastasis. EMT is induced by transforming growth factor-beta (TGF-β) or receptor tyrosine kinase (RTK) ligands, which further...
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Foot metastasis: Current knowledge.

Tommaso Greco1,2, Luigi Cianni1,2, Domenico De Mauro1,2

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|September 11, 2020
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Metastatic disease in the foot is rare, often presenting as pain and swelling, delaying diagnosis. Lung, endometrial, and breast cancers are common primary sources, with calcaneus and metatarsals frequently affected.

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Area of Science:

  • Oncology
  • Orthopedics
  • Radiology

Background:

  • Foot metastasis are uncommon and frequently overlooked due to nonspecific symptoms.
  • Delayed diagnosis of metastatic disease to the foot can result from not considering it in the differential diagnosis of foot pain and swelling.

Purpose of the Study:

  • To analyze existing literature on foot metastasis cases.
  • To determine the incidence of symptomatic foot acrometastasis.
  • To review the clinical course and outcomes of patients with foot metastasis.

Main Methods:

  • A systematic literature search was conducted on PubMed/Medline from database inception to February 2020.
  • Studies including case reports of foot metastasis, with or without a known primary tumor, were included.
  • Two additional case reports from the authors' institute were incorporated.

Main Results:

  • Forty-three studies comprising 45 patients were reviewed, predominantly case reports of older patients (average age 63.2) in advanced disease stages.
  • Lung cancer was the most frequent primary tumor, followed by endometrial and breast cancer.
  • Foot metastasis was the initial sign of malignancy in 36% of cases, with the calcaneus and metatarsals being the most commonly involved bones.

Conclusions:

  • Surgical intervention for foot metastasis is infrequent, with palliative care being the common treatment approach.
  • The prognosis for patients with foot metastasis is often poor, with approximately 50% mortality within two years of diagnosis.