Abstract
Lung cancer is commonly diagnosed at advanced stages, often presenting with metastases. Although bone metastases are common in lung cancer patients, acrometastases - metastatic lesions in the bones of the hand - are exceedingly rare. Herein, we report the case of a 71-year-old male with previously undiagnosed lung adenocarcinoma, which first manifested as a painful swelling in the right hand. Radiographic imaging and biopsy revealed a bone metastasis involving the third metacarpal and phalanges, secondary to lung adenocarcinoma. Three weeks after the biopsy, the hand tumor became severely ulcerated, leading to a significant drop in hemoglobin levels, necessitating an urgent amputation as a life-saving measure. This case highlights the diagnostic challenges of rare metastatic patterns and emphasizes the need for timely and accurate diagnosis to improve outcomes. Clinicians should consider metastases in the differential diagnosis of unexplained hand swelling, and early intervention is critical in managing such aggressive cases.