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[Clinical Picture] Synchronous distal phalangeal metastases from primary non-small-cell lung cancer

A 78-year-old man was admitted to hospital for treatment of stage IIIa squamous cell carcinoma of the lung. He reported a 4 week history of pain, erythema, and oedema in the left middle finger tip, which impaired his sleep and hand function. The patient denied any preceding trauma, and had no clinical or laboratory features of systemic infection. He also reported increasing pain in the contralateral little finger tip, with mild oedema and erythema developing in the preceding fortnight.