Metastasis of esophageal carcinoma manifesting as whitlow-like lesions

A rare case of phalangeal metastasis of esophageal carcinoma in an 81-year-old man is described. The patient developed a tender, red, and swollen right index finger. From the clinical features, he was erroneously diagnosed with whitlow at first and treated with antibiotics with no success. A bone X-ray showed that the distal phalanx of the index finger was completely dissolved. Histopathological examination revealed proliferation of squamous cell carcinoma into the deep dermis. It is important to understand that the phalangeal metastases commonly display inflammatory symptoms that mimic acute infection.