Bone metastasis to the foot: Report of three cases

Bone metastases to the foot are rare and often misdiagnosed. Only tarsal localizations are relatively frequent. Primary tumours are mostly adenocarcinomas (colon, kidneys, lungs). Three cases of acrometastases, localized, respectively, on the ungual phalanx of the hallux, the first metatarsal and the first cuneiform, are reported. Primitive tumour sites differed in the three cases (renal, pulmonary and mammary origin). Adequate therapy must be preceded by an accurate staging. Surgery should aim to excise the tumour and restore, when possible, a good function of the foot without any pain. Amputation should only be resorted to if is not possible to perform the excision of the tumour in patients whose life expectancy is not too short. Wide local and systemic diffusion of the tumour and a short life expectancy contraindicate any surgical approach. Treatment, in these cases, must try to achieve a satisfactory pain control and decrease the local expansion of the tumour.