Metastatic bronchogenic carcinoma masquerading as a felon

Area of Science:

• Oncology
• Dermatology
• Pathology

Background:

• Bronchogenic carcinoma, a common lung cancer, rarely presents with distal extremity metastases.
• Subcutaneous metastases can mimic benign or infectious processes, delaying diagnosis.

Observation:

• A patient presented with a distal fingertip lesion initially suspected to be infectious.
• Clinical presentation included erythema and swelling, consistent with an abscess or cellulitis.

Findings:

• Roentgenograms showed no initial signs of bone involvement.
• Cultures were sterile, ruling out an infectious etiology.
• Biopsy confirmed subcutaneous metastatic bronchogenic carcinoma, with secondary involvement of adjacent bone.

Implications:

• This case highlights the importance of considering metastatic disease in unexplained fingertip lesions.
• Early diagnosis of metastatic bronchogenic carcinoma is crucial for appropriate management.
• Subcutaneous metastases can present insidiously, requiring thorough investigation.