Overview

• A 55-year-old Australian man with metastatic squamous-cell lung cancer experienced acrometastases that completely replaced the bones in his right middle finger and big toe.
• Radiographs identified destructive lytic lesions in the distal phalanges, confirming an acrometastasis occurrence that represents roughly 0.1% of bone metastases.
• Six weeks of painful swelling and clubbing had mimicked benign conditions like gout or infection, highlighting the need for imaging in atypical digital presentations.
• The patient underwent palliative radiotherapy to relieve symptoms but died three weeks later from refractory hypercalcemia, a common fatal complication in advanced cancer.
• Published in the July 2025 issue of The New England Journal of Medicine, the report calls for heightened clinical vigilance for atypical bone metastases in unexplained swellings.