Metastases to rare locations as the initial manifestation of non-small cell lung cancer: two case reports.

Non-small cell lung cancer is the most common type of lung cancer (about 80% of all lung cancers). It grows and spreads more slowly than small cell lung cancer, but still, when the primary tumour treatment starts, about 60% of patients with cancer already have some kind of malignant cell spreading. Metastases to hand bones and skeletal muscles are very rare (metastatic hand lesions represent 0.1% of all osseous metastases while metastases to muscles represent from 0.8 to 16% incidence in autopsy series); in case of metastases in such sites it can be usually expected to find metastases disseminated all over the body. Fine needle aspiration cytology has an important role to give accurate diagnosis or at least diagnosis of suspicion and thus to set the guidelines to a clinician for the further specific and cost-effective treatment. We will show two cases where the metastases of non-small cell lung carcinoma were the first signs of the disease located in uncommon body parts: a man with the metastasis to distal phalanx of the right thumb and a woman with nodal metastasis to the right gluteal muscle and subcutaneous tissue near muscle which show us that we have to pay our attention to the potential development of such lesions even on rare locations and even when there are no other symptoms. In both cases, patients did not have any other symptoms related to the lung cancer.