A Case of Metastasis of Rectal Cancer to the Left Fourth Finger Middle Phalanx

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  • 左第四指中節骨に転移を来した直腸癌の1例

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Abstract

<p>Among bone metastases of colorectal cancer, metastasis to finger bones is extremely rare. We report a case of metastasis to the middle phalanx of the left fourth finger, which was found due to finger pain after surgery for rectal cancer. The patient was an 80-year-old woman who underwent lower endoscopy at a previous hospital due to bloody stool and was found to have a circumferential type 2 lesion in rectosigmoid colon (RSRa). A biopsy revealed adenocarcinoma, rectal cancer was diagnosed, and laparoscopic-assisted low anterior resection and transverse colon colostomy were performed. Five days after the operation, swelling and pain occurred in the left fourth middle phalanx and a fracture was diagnosed. Conservative treatment with immobilization was performed, but reassessment one month later revealed that the fracture had worsened, suggesting bone metastasis of rectal cancer. Left fourth finger amputation was performed for pain control and definitive diagnosis. Pathological findings led to diagnosis of adenocarcinoma, which was considered to be a metastasis of rectal cancer. The patient had a performance status of 4 and decreased activity, and was transferred 70 days after the rectal cancer surgery. Ten months after diagnosis of the fracture, she is still alive. Amputation of the affected finger relieved pain and improved QOL.</p>

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