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Acrometastases to the Hand: A Systematic Review
Giuseppe Emmanuele Umana1, Gianluca Scalia2, Paolo Palmisciano1
1Trauma Center, Gamma Knife Center, Department of Neurosurgery, Cannizzaro Hospital, 95126 Catania, Italy.
Medicina (Kaunas, Lithuania)
|September 28, 2021
Summary
Acrometastases, or secondary bone lesions in the hands and feet, are increasingly recognized. This review highlights their late-stage development and emphasizes updated surgical management for improved patient prognosis.
Area of Science:
- Oncology
- Orthopedics
- Radiology
Background:
- Acrometastases (AM) are rare bony metastases distal to the elbow and knee, accounting for 0.1% of all bone metastases.
- Pulmonary, gastrointestinal, and genitourinary cancers are the most common primary sources of AM.
- Advances in cancer care are leading to an increased incidence of these rare cases.
Purpose of the Study:
- To conduct a systematic review of acrometastases to the hand.
- To provide insights into the management of patients with acrometastases.
- To report a unique case of simultaneous acrometastasis to the ring finger and vertebral fracture.
Main Methods:
- A systematic literature search was performed using PRISMA guidelines.
- Databases searched included PubMed, Google Scholar, and Scopus (1986-2020).
- MeSH terms focused on hand, wrist, carpal, finger, and phalangeal metastases.
Main Results:
- 215 studies involving 247 patients (median age 62) were analyzed.
- Acrometastases were most commonly located in the finger/phalanx (68.4%), followed by carpal and metacarpal sites (14.2% each).
- Pulmonary cancer was the most frequent primary tumor (36.8%), with a median time from diagnosis to metastasis of 24 months.
Conclusions:
- Acrometastases typically indicate late-stage cancer with a poor prognosis.
- The incidence of acrometastases is rising and should not be considered rare.
- Physicians need updated knowledge on surgical management and prognostic impact of acrometastases.
