Hiroshi Watanabe, Eiichi Sato, Sayaka Yamada, Satoshi Anayama, Yoshiki Hamada, Ryouhei Kato.
Metastatic tumor of the capitate bone: A case report
J Surg Jun 2004;27(1):65-8.
Yamanashi University School of Medicine, Yamanashi, Japan
An 80-year-old man became aware of weakness of his left hand one month before the first visit to this department. As pain and swelling of his left wrist occurred subsequently, he came to us. He had been diagnosed of pulmonary emphysema for two years and lung cancer (adenocarcinoma) for one year. He had undergone radiotherapy for lung cancer and the course of illness was being observed at the medical department of this hospital. On the first examination, redness; heat sensation and swelling were observed on the dorsal surface of the left wrist. Due to pain, the range of motion (ROM) of the wrist and interphalangeal (IP) joints was markedly restricted; ROM of the IP joint was -20 to 40 degrees and the metacarpophalangeal joint was -10 to 40 degrees. Plain radiograph showed marked atrophy of the carpal bones and destruction of the capitate bone. Tomography and computed tomography (CT) revealed bone destruction and osteolysis limited to the capitate bone. From the above findings, osteomyelitis or metastasis of lung cancer to the capitate bone was suspected, and biopsy was performed. This established a diagnosis of metastasis of adenocarcinoma of the lung. Curettage of the lesion or amputation was initially planned to improve pain, however, respiratory function rapidly deteriorated. The capitate bone was thus treated with 28Gy radiation and bracing. He was also given 60 mg/day of morphine hydrochloride orally. His family considering its physiological impacts on the patient earlier refused amputation. Pain at the left wrist was relieved after the radiation therapy but the patient died of advanced lung cancer about three months after the first visit to this department.
Category: Case Reports
Keywords: Cancer. Capitate Bone.
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