Skuamöz hücreli akciğer kanseri metastatik olmaktan ziyade lokal bir hastalıktır. Bu çalışmamızda sunduğumuz lokal ilerlemiş skuamöz hücreli akciğer kanseri tanısı alan 55 yaşındaki erkek hasta, 2 ay sonra ortopedi kliniğine sol ayak bileği çevresinde ağrı ve rahatsızlık şikayetiyle başvurmuştu. Fizik muayenede ayak bileği çevresinde lokalize edilemeyen ağrı ve hassasiyet saptanmıştır. T2 ağırlıklı MR görüntülerinde talus başı ve boynu çevresinde kemik iliği ödemi benzeri alanlar görülmüştür. Tüm vücut dinamik kemik sintigrafisinde sadece ayakta metastatik bir lezyon saptanmıştır. Hasta metastaz tanısı koyulmasının ardından 4 ay sonra kaybedilmiştir. Ayak metastazının erken tanısı zorlu bir süreç olmakla beraber yapılan çalışmalarda tanının konulmasında 24 aya varan gecikmelerden bahsedilmektedir. Kemik metastazları genellikle ilerlemiş metastatik hastalıkla birlikte görülür ve sağkalım beklentisi çok düşüktür. Ayak metastazları nadir görülmelerine rağmen yaşlı bir akciğer kanseri hastasında ağrılı bir ayağın tanı sürecinde akılda tutulmalıdır. Yaşam süresi beklentisinin kısa olduğu hastalarda ağrı kesiciler gibi palyatif tedavilerin seçilmesi daha uygun olacakken, uzun yaşam süresi beklenen hastalarda ise agresif tedavi yaklaşımları uygulanabilir.
Nakashima Y. Metastases involving bone. In: Folpe AL, Inwards CY, editors. Bone and soft tissue pathology. 1st ed. Philadelphia: Saunders Elsevier; 2010. p. 446-53. CrossRef
Johnston AD. Pathology of metastatic tumors in bone. Clin Orthop Relat Res 1970;73:8-32. CrossRef
Healey JH, Turnbull AD, Miedema B, Lane JM. Acro- metastases. A study of twenty-nine patients with osseous involvement of the hands and feet. J Bone Joint Surg Am 1986;68:743-6.
Abrahams TG. Occult malignancy presenting as meta- static disease to the hand and wrist. Skeletal Radiol 1995;24:135-7. CrossRef
Libson E, Bloom RA, Husband JE, Stoker DJ. Metastatic tumours of bones of the hand and foot. A comparative review and report of 43 additional cases. Skeletal Radiol 1987;16:387-92. CrossRef
Baran R, Tosti A. Metastatic carcinoma to the terminal phalanx of the big toe: report of two cases and review of the literature. J Am Acad Dermatol 1994;31:259-63. CrossRef
Greenlee RT, Hill-Harmon MB, Murray T, Thun M. Cancer statistics, 2001. CA Cancer J Clin 2001;51:15- 36. CrossRef
Strauss B, Weller CV. Bronchogenic carcinoma; a statisti- cal analysis of two hundred ninety-six cases with necropsy as to relationships between cell types and age, sex, and me- tastasis. AMA Arch Pathol 1957;63:602-11.
Mountain CF, Lukeman JM, Hammar SP, Chamberlain DW, Coulson WF, Page DL, et al. Lung cancer classifi- cation: the relationship of disease extent and cell type to survival in a clinical trials population. J Surg Oncol 1987;35:147-56. CrossRef
Hansen HH, Muggia FM. Staging of inoperable patients with bronchogenic carcinoma with special reference to bone marrow examination and peritoneoscopy. Cancer 1972;30:1395-401. CrossRef
Bos GD, Esther RJ, Woll TS. Foot tumors: diagnosis and treatment. J Am Acad Orthop Surg 2002;10:259-70.
Zindrick MR, Young MP, Daley RJ, Light TR. Metastatic tumors of the foot: case report and literature review. Clin Orthop Relat Res 1982;170:219-25.
Hattrup SJ, Amadio PC, Sim FH, Lombardi RM. Metastatic tumors of the foot and ankle. Foot Ankle 1988;8:243-7. CrossRef
Krishnamurthy GT, Tubis M, Hiss J, Blahd WH. Distri- bution pattern of metastatic bone disease. A need for total body skeletal image. JAMA 1977;237:2504-6. CrossRef
Weidmann CE, Ganz PA. Multiple synchronous lesions of acral metastasis. West J Med 1984;140:451-6.
Maheshwari AV, Chiappetta G, Kugler CD, Pitcher JD Jr, Temple HT. Metastatic skeletal disease of the foot: case reports and literature review. Foot Ankle Int 2008;29:699- 710. CrossRef
Wu KK, Guise ER. Metastatic tumors of the foot. South Med J 1978;71:807-12. CrossRef
Berlin SJ. A laboratory review of 67,000 foot tumors and lesions. J Am Podiatry Assoc 1984;74:341-7. CrossRef
Kouvaris JR, Kouloulias VE, Papacharalampous XN, Koutselini HA, Gennatas CS, Limouris GS, et al. Isolated talus metastasis from breast carcinoma: a case report and review of the literature. Onkologie 2005;28:141-3. CrossRef
Richter D, Hahn MP, Bosse A, Dávid A, Muhr G. Iso- lated talus metastasis of an occult bronchial carcinoma--a rare cause for chronic foot disorders. [Article in German] Zentralbl Chir 1994;119:726-9. [Abstract]
Isolated foot metastasis of squamous cell carcinoma of the lung: a rare location
Year 2014,
Volume: 48 Issue: 6, 693 - 697, 16.01.2015
Squamous cell carcinoma of the lung usually presents as a local rather than a metastatic disease. We present a 55-year-old male who was referred to the orthopedics and traumatology clinic for evaluation of pain and discomfort around the left ankle 2 months after diagnosis of locally advanced non-small cell (squamous cell) lung cancer. Physical examination revealed nonspecific pain and tenderness around the ankle. T2-weighted MR images showed lesions like a bone marrow edema around the talar head and neck. Whole body dynamic bone scan revealed a metastatic lesion only in the foot. The patient died 4 months after diagnosis of the metastasis. Early diagnosis of foot metastasis may be challenging and delays in diagnosis of up to 24 months have been reported. Foot metastases are usually associated with advanced metastatic disease and survival rates are poor. Although metastatic disease of the foot is rare, it should be considered in the diagnosis of a painful foot in the elderly lung cancer patients. Palliative treatments such as pain relief medications should be chosen for patients with an expectancy of short survival whereas aggressive approaches may be applied for those with longer survival expectations.
Nakashima Y. Metastases involving bone. In: Folpe AL, Inwards CY, editors. Bone and soft tissue pathology. 1st ed. Philadelphia: Saunders Elsevier; 2010. p. 446-53. CrossRef
Johnston AD. Pathology of metastatic tumors in bone. Clin Orthop Relat Res 1970;73:8-32. CrossRef
Healey JH, Turnbull AD, Miedema B, Lane JM. Acro- metastases. A study of twenty-nine patients with osseous involvement of the hands and feet. J Bone Joint Surg Am 1986;68:743-6.
Abrahams TG. Occult malignancy presenting as meta- static disease to the hand and wrist. Skeletal Radiol 1995;24:135-7. CrossRef
Libson E, Bloom RA, Husband JE, Stoker DJ. Metastatic tumours of bones of the hand and foot. A comparative review and report of 43 additional cases. Skeletal Radiol 1987;16:387-92. CrossRef
Baran R, Tosti A. Metastatic carcinoma to the terminal phalanx of the big toe: report of two cases and review of the literature. J Am Acad Dermatol 1994;31:259-63. CrossRef
Greenlee RT, Hill-Harmon MB, Murray T, Thun M. Cancer statistics, 2001. CA Cancer J Clin 2001;51:15- 36. CrossRef
Strauss B, Weller CV. Bronchogenic carcinoma; a statisti- cal analysis of two hundred ninety-six cases with necropsy as to relationships between cell types and age, sex, and me- tastasis. AMA Arch Pathol 1957;63:602-11.
Mountain CF, Lukeman JM, Hammar SP, Chamberlain DW, Coulson WF, Page DL, et al. Lung cancer classifi- cation: the relationship of disease extent and cell type to survival in a clinical trials population. J Surg Oncol 1987;35:147-56. CrossRef
Hansen HH, Muggia FM. Staging of inoperable patients with bronchogenic carcinoma with special reference to bone marrow examination and peritoneoscopy. Cancer 1972;30:1395-401. CrossRef
Bos GD, Esther RJ, Woll TS. Foot tumors: diagnosis and treatment. J Am Acad Orthop Surg 2002;10:259-70.
Zindrick MR, Young MP, Daley RJ, Light TR. Metastatic tumors of the foot: case report and literature review. Clin Orthop Relat Res 1982;170:219-25.
Hattrup SJ, Amadio PC, Sim FH, Lombardi RM. Metastatic tumors of the foot and ankle. Foot Ankle 1988;8:243-7. CrossRef
Krishnamurthy GT, Tubis M, Hiss J, Blahd WH. Distri- bution pattern of metastatic bone disease. A need for total body skeletal image. JAMA 1977;237:2504-6. CrossRef
Weidmann CE, Ganz PA. Multiple synchronous lesions of acral metastasis. West J Med 1984;140:451-6.
Maheshwari AV, Chiappetta G, Kugler CD, Pitcher JD Jr, Temple HT. Metastatic skeletal disease of the foot: case reports and literature review. Foot Ankle Int 2008;29:699- 710. CrossRef
Wu KK, Guise ER. Metastatic tumors of the foot. South Med J 1978;71:807-12. CrossRef
Berlin SJ. A laboratory review of 67,000 foot tumors and lesions. J Am Podiatry Assoc 1984;74:341-7. CrossRef
Kouvaris JR, Kouloulias VE, Papacharalampous XN, Koutselini HA, Gennatas CS, Limouris GS, et al. Isolated talus metastasis from breast carcinoma: a case report and review of the literature. Onkologie 2005;28:141-3. CrossRef
Richter D, Hahn MP, Bosse A, Dávid A, Muhr G. Iso- lated talus metastasis of an occult bronchial carcinoma--a rare cause for chronic foot disorders. [Article in German] Zentralbl Chir 1994;119:726-9. [Abstract]
Kaynak, G., Yildirim, E., Botanlioglu, H., Ogut, T. (2015). Isolated foot metastasis of squamous cell carcinoma of the lung: a rare location. Acta Orthopaedica Et Traumatologica Turcica, 48(6), 693-697. https://doi.org/10.3944/AOTT.2014.13.0049
AMA
Kaynak G, Yildirim E, Botanlioglu H, Ogut T. Isolated foot metastasis of squamous cell carcinoma of the lung: a rare location. Acta Orthopaedica et Traumatologica Turcica. January 2015;48(6):693-697. doi:10.3944/AOTT.2014.13.0049
Chicago
Kaynak, Gokhan, Enis Yildirim, Huseyin Botanlioglu, and Tahir Ogut. “Isolated Foot Metastasis of Squamous Cell Carcinoma of the Lung: A Rare Location”. Acta Orthopaedica Et Traumatologica Turcica 48, no. 6 (January 2015): 693-97. https://doi.org/10.3944/AOTT.2014.13.0049.
EndNote
Kaynak G, Yildirim E, Botanlioglu H, Ogut T (January 1, 2015) Isolated foot metastasis of squamous cell carcinoma of the lung: a rare location. Acta Orthopaedica et Traumatologica Turcica 48 6 693–697.
IEEE
G. Kaynak, E. Yildirim, H. Botanlioglu, and T. Ogut, “Isolated foot metastasis of squamous cell carcinoma of the lung: a rare location”, Acta Orthopaedica et Traumatologica Turcica, vol. 48, no. 6, pp. 693–697, 2015, doi: 10.3944/AOTT.2014.13.0049.
ISNAD
Kaynak, Gokhan et al. “Isolated Foot Metastasis of Squamous Cell Carcinoma of the Lung: A Rare Location”. Acta Orthopaedica et Traumatologica Turcica 48/6 (January 2015), 693-697. https://doi.org/10.3944/AOTT.2014.13.0049.
JAMA
Kaynak G, Yildirim E, Botanlioglu H, Ogut T. Isolated foot metastasis of squamous cell carcinoma of the lung: a rare location. Acta Orthopaedica et Traumatologica Turcica. 2015;48:693–697.
MLA
Kaynak, Gokhan et al. “Isolated Foot Metastasis of Squamous Cell Carcinoma of the Lung: A Rare Location”. Acta Orthopaedica Et Traumatologica Turcica, vol. 48, no. 6, 2015, pp. 693-7, doi:10.3944/AOTT.2014.13.0049.
Vancouver
Kaynak G, Yildirim E, Botanlioglu H, Ogut T. Isolated foot metastasis of squamous cell carcinoma of the lung: a rare location. Acta Orthopaedica et Traumatologica Turcica. 2015;48(6):693-7.