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BMJ Case Rep. 2010; 2010: bcr05.2009.1912.
Published online 2010 January 13. doi:  10.1136/bcr.05.2009.1912
PMCID: PMC3029992
Reminder of important clinical lesson

Rapidly progressive bone destruction of the finger as first presentation of systemic metastases from lung cancer


We report a case of a man with locally advanced lung adenocarcinoma and no evidence of metastatic disease presenting with rapid onset pain and swelling of his right second finger. Radiographically and clinically this was felt to be osteomyelitis and he was treated with intravenous antibiotics. He clinically worsened, and upon biopsy was found to have metastatic adenocarcinoma of the digit. He was treated with radiotherapy with some symptom improvement. He shortly thereafter developed diffuse skeletal metastases.

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