1. Palliative and Supportive Care in Acrometastasis to the Hand: Case Series
- Author
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Anjan Bera, Narendra Kumar, Shabab Lalit Angurana, Ritesh Kumar, Sushmita Ghosal, Suresh C. Sharma, Pankaj Kumar, and Radhika Srinivasan
- Subjects
Larynx ,Palliative Radiation Therapy ,Pamidronate ,Case Report ,Hematological malignancies ,WHO pain ladder ,Noncancer ,Squamous cell carcinoma ,Squamous cell carcinoma of the skin ,Painful bone metastasis ,Cancer pain ,Cancer ,Professional behavior ,lcsh:R5-920 ,Health Policy ,Doctors ,Bisphosphonates ,Dysphagia ,Blood-related cancers ,medicine.anatomical_structure ,Informal caregiver ,Journal reporting ,Psychosocial issues ,Speech language pathologists ,Ibandronate ,Palliative care ,Hypofractionation ,Presentation (obstetrics) ,lcsh:Medicine (General) ,Skeletal-related events ,Terminally ill ,Cancer survivorship ,Quality of life ,medicine.medical_specialty ,Poor prognosis ,Pain assessment ,Professional psychology ,Saudi Arabia ,Pain ,India ,Disfigurement ,Publication trend ,Peripheral arterial disease ,Speech deficits ,medicine ,Esophagus ,Radical therapy ,Intensive care medicine ,Zoledronic acid ,Acrometastasis ,Palliative ,Hemostasis ,Undertreatment of cancer pain ,Radiotherapy ,business.industry ,Euthanasia ,Evidence-based pediatric palliative care ,General surgery ,Research ,Sickle cell disease ,Public Health, Environmental and Occupational Health ,medicine.disease ,Attitudes ,Opioid analgesics ,Buccal mucosa ,Nursing education ,business ,Needs - Abstract
Acrometastasis to the hand is an unusual presentation which might mimic an infectious, inflammatory, or a metabolic pathology. We herein describe a case series of three patients of acrometastasis to the hand. We encountered three cases of acrometastasis to the hand attending the departmental clinics from 2007 to 2010. The median age at presentation was noted to be 55 years. All were males. The primaries included squamous cell carcinoma of the skin, larynx, and esophagus. In two patients, acrometastasis was detected at presentation and in one it was detected 2 years postcompletion of radical therapy. Two patients were offered palliative radiation to acrometastasis, and best supportive care was given to one. Palliation achieved after radiation was noted to be modest to good. The brief report highlights the importance of the clinical awareness of metastatic dissemination to unusual sites in the face of increasing cancer survivorship. Acrometastasis portends a poor prognosis with limited survival, and optimal integration of the best supportive care is mandatory. A short course of hypofractionated palliative radiation therapy results in modest to good palliation.
- Published
- 2011