An unusual case of finger swelling: A case report
Cases Journal volume 2, Article number: 155 (2009)
A 66 year old man initially presented with haemoptysis and subsequently required a pneumonectomy for a lung mass, following this he had a finger swelling which was found to be a rare leiomyosarcoma and this was a metastatic deposit. This pattern of metastasis for this type of tumour has not been described before.
A 66-year-old man, with a previous left ring finger ganglion, presented with haemoptysis. Radiographic investigations revealed a left lung mass; he underwent a left pneumonectomy for this. The lesion was found to be a rare pulmonary leiomyosarcoma. No further treatment was required, until he was referred to Orthopaedic Surgery, with a possible recurrent left ring finger ganglion (see Figure 1.). This was excised and also found to be a leiomyosarcoma; he therefore had a ray amputation. The sequence of events suggested a primary pulmonary leiomyosarcoma with a metastatic digit deposit, which is extremely rare. Primary leiomyosarcoma of the uterus with pulmonary metastases is a more common presentation . He was referred to Oncology and further limb leiomyosarcomas were found. He therefore had chemotherapy, but died soon afterwards with metastatic leiomyosarcoma. So appearances are not always what they seem.
Written informed consent could not be obtained because the patient was deceased. We believe this case report holds a worthwhile clinical lesson which could not be communicated effectively in any other way. Every effort has been made to keep the patient's identity anonymous. We would not expect the patient or their family to object to publication.
Gal AA, Brooks JSJ, Pietra GG: Leiomyomatous neoplasms of the lung: A clinical, histologic and immunohistochemical study. Modern Pathology. 1989, 2: 209-16.
The authors declare that they have no competing interests.
RMG and MCS analysed and interpreted the patient data from the case notes. GPA provided the clinical image and was a major contributor in both suggesting the report and reviewing the manuscript. All authors read and approved the final manuscript.
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Graham, R.M., Sharp, M.C. & Ashcroft, G.P. An unusual case of finger swelling: A case report. Cases Journal 2, 155 (2009). https://doi.org/10.1186/1757-1626-2-155