[Distal bone metastases of the upper limb].

This work is based on a review of 120 peripheral bone metastases of the upper limbs found in the literature and 10 others selected from a personal series of 469 cases of bone metastases. The authors stress the scarcity of these lesions (2%), metastases arising in bones of the forearm are usually part of a widespread osseous involvement, generally of mammary or prostatic origin. Metastases to the bones of the hand are more peculiar: 1) Those from bronchogenic carcinoma account for 50%. 2) Resultant soft tissue necrosis creates swelling, redness, heat and pain, which can mimic acute osteomyelitis. 3) X-rays reveal isolated osteolysis affecting metacarpals, phalanges, or more rarely carpal bones. Distal location of those metastases does not modify therapeutic management amputation is the best effective palliative treatment and must be discussed every time there is a concomitant skin ulceration, or if bone metastasis is unique or if the primary tumor is cured or accessible to treatment.