The Dog Bite, the Acrometastasis and the Disappearing Hamate

Area of Science:

• Oncology
• Pathology
• Radiology

Background:

• Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive subtype of non-small cell lung cancer.
• Acrometastases, bony metastases distal to the elbow and knee, are typically diagnosed after the primary tumor is identified.

Observation:

• A patient presented with wrist pain following a dog bite, leading to the discovery of a hamate metastasis.
• This metastasis was subsequently diagnosed as basaloid squamous cell carcinoma of the lung.

Findings:

• The case highlights an unusual presentation where the acrometastasis was diagnosed prior to the primary lung tumor.
• Classical features of acrometastasis were observed, prompting further investigation.

Implications:

• This case underscores the importance of considering unusual presentations in cancer diagnosis.
• It emphasizes the need for thorough investigation of seemingly minor injuries that may reveal underlying metastatic disease.
• Reviewing literature on acrometastases and BSCC can improve diagnostic strategies for rare presentations.