Digital acrometastase as a primary manifestation of a bronchial adenocarcinoma

Bone metastases of the hands and feet (acrometastases) are rare. Their presentation is variable and is generally confused with certain inflammatory conditions such as rheumatoid arthritis, gout, tenosynovitis, fracture or infection (panartius, osteomyelitis). The etiology of non-digital acrometastases is common to primary tumors with bone metastases (prostate, lung, kidney, breast, thyroid, and digestive tube). However, digital acrometastases are seen almost exclusively during bronchial neoplasia. We describe the case of a 43 year-old man admitted for pain and swelling of the middle finger distal phalanx of the left hand. Etiological assessement was in favor of an unusual secondary localization of bronchial adenocarcinoma. Tumoral causes must always be evoked before any inflammatory digital symptomatology, from where the interest of a good interrogation and a targeted paraclinical assessment.