Abstract
Acrometastasis is an extremely rare diagnosis, invariably associated with poor prognosis. A 60-year-old female with complaints of cough and breathing difficulty also presented with pain and swelling in her left leg. Radiological investigations suggested a double primary in the lung and leg; histopathology and immunohistochemistry (IHC) confirmed the lesion in the leg to be metastatic from the lung primary. There should always be a high index of suspicion for acrometastasis in lung adenocarcinoma, as it is the most common malignancy to metastasize to the acral sites, followed by renal cell carcinoma, breast carcinoma, and colon carcinoma. The correct approach to tumors at several sites, in conjunction with history, radiology, and pathology, would aid in the timely and accurate diagnosis for proper patient management.