Bladder cancer presenting with acrometastases: a different cause of foot pain

Skeletal Radiol. 2018 Jul;47(7):1003-1009. doi: 10.1007/s00256-018-2888-6. Epub 2018 Feb 1.

Abstract

Acrometastasis means tumor seeding distally to the elbow or the knee and is an uncommon event. Foot acrometastases occur in 0.58% of patients with skeletal metastases overall, and only about 10% of these are caused by bladder cancer. We present a case of bladder cancer manifesting with insidious foot pain, caused by multiple lytic lesions located solely at the left foot. It was suspected after whole-body CT and later confirmed by biopsy result. We enumerate the differential diagnosis of distal extremity lytic lesions for educational purposes and review the literature listing similar published cases.

Keywords: Foot acrometastasis; Lytic skeletal lesions; Transitional cell carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biopsy
  • Bone Neoplasms / diagnostic imaging*
  • Bone Neoplasms / secondary*
  • Carcinoma, Transitional Cell / diagnostic imaging*
  • Carcinoma, Transitional Cell / secondary*
  • Diagnosis, Differential
  • Female
  • Foot Diseases / diagnostic imaging*
  • Foot Diseases / pathology*
  • Humans
  • Pain
  • Pain Measurement
  • Tomography, X-Ray Computed*
  • Urinary Bladder Neoplasms / pathology*