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To the Editor.—
The recent report "Phalangeal Metastases From Bronchogenic Carcinoma" (239:226, 1978) verifies the uncommon occurrence of metastatic implants in digits giving the appearance of osteomyelitis or gout. The authors emphasize the presentation of their cases with involvement of a single toe or finger, but actually bone scans and roentgenograms showed polyarticular disease.We reported a similar case (179:162, 1962) in which five fingers showed metastases from bronchogenic carcinoma. Our initial diagnosis was rheumatoid arthritis because of the symmetrical fusiform swellings present in our patient. The physician, therefore, should be alert to the fact that swellings in three or more digits resembling rheumatoid arthritis, and not just monarticular disease, may occasionally be from metastases from carcinoma of the lung.
Karten I. Phalangeal Metastases From Bronchogenic Carcinoma. JAMA. 1978;239(23):2449. doi:10.1001/jama.1978.03280500045014
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