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CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2022; 50(01): e19-e26
DOI: 10.1055/s-0042-1744260
Original Article | Artículo Original

Acrometástasis en mano y muñeca: Serie de 9 casos y revisión de la literatura

Article in several languages: English | español
D. Valverde-Vilamala
1   Parc de Salut Mar, Barcelona, Cataluña, Spain
,
A. Sala-Pujals
1   Parc de Salut Mar, Barcelona, Cataluña, Spain
,
J. Cebamanos
1   Parc de Salut Mar, Barcelona, Cataluña, Spain
,
E. Dominguez-Font 
1   Parc de Salut Mar, Barcelona, Cataluña, Spain
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Resumen

Introducción Las acrometástasis son extremadamente raras en la mano, con una prevalencia alrededor de un 0,1% según la literatura. Normalmente se asocian a patologías tumorales en estadios evolucionados, especialmente el carcinoma de pulmón. En este trabajo se muestra la experiencia de nuestro centro en el manejo y el tratamiento de estas entidades.

Materiales y métodos Describimos una serie de 9 casos tratados entre 1992 y 2020 de acrometástasis en la mano y muñeca. Se analizan datos de tumor primario, órgano diana, tratamiento y supervivencia. Asimismo, se realiza una revisión de los casos de acrometástasis de la literatura, haciendo hincapié en cuántos de ellos la lesión acra fue el primer signo de patología tumoral desconocida.

Resultados Se objetiva que afectan predominantemente a varones alrededor de 60 años, y que el tumor primario causante en la mayoría de los casos es el de pulmón, con una supervivencia del paciente tras el diagnóstico muy baja (alrededor de 8 meses).

Discusión y conclusiones Ante una lesión acra de origen no traumático, hay que tener en cuenta las acrometástasis, especialmente en pacientes que tienen un tumor primario conocido. En esta serie hubo tres casos en los que las acrometástasis fueron el primer signo de la patología tumoral del paciente, y en uno de ellos se le trató erróneamente como un panadizo inicialmente. En la literatura, aproximadamente el 50% de las acrometástasis son el primer signo de patología tumoral.

Una vez diagnosticado, el tratamiento multidisciplinar médico-quirúrgico es fundamental para mejorar la función y el dolor del paciente en la medida de lo posible.

Palabras clave

acrometástasis - mano - lesión acra - dedo - metástasis ósea


Publication History

Received: 29 September 2021

Accepted: 26 January 2022

Article published online:
23 June 2022

© 2022. SECMA Foundation. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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