Metastatic skeletal disease of the foot: Case reports and literature review

Aditya V. Maheshwari, Geno Chiappetta, Carlos D. Kugler, J. David Pitcher, H. Thomas Temple

Research output: Contribution to journalReview articlepeer-review

54 Scopus citations


Background: Metastatic disease of the skeleton occurs in at least 20% to 30% of patients with malignancy, but metastasis to the foot and hand (acrometastasis) is extremely rare (0.007% to 0.3%). Metastases to the feet are even rarer and have been reported in half to one-third the rate for hand metastases. Failure to recognize these lesions has led to delayed diagnosis and/or inappropriate treatment. The purpose of this report is to highlight the clinical and radiologic features that aid in the diagnosis and potential treatment of this condition along with a pertinent review of the literature. Materials and Methods: In a retrospective review of 694 patients with histologically proven metastatic skeletal disease (January 1988 to January 2007), 14 cases of metastatic lesions to the foot were identified. Results: The most frequent primary site was in the genito-urinary system in eight patients and the most common bones involved were the calcaneus and the talus in six patients each. All patients died after a mean survival of 14.8 (range, 1 to 54) months after diagnosis of metastases. Conclusion: Although metastatic disease of the foot is rare, it should be considered in the diagnosis of a painful foot, especially if suspicious radiographic changes are present in an older patient. The common primary sites are the genito-urinary, lungs, breast, and the colo-rectum. Treatment is usually palliative to reduce pain and maintain function.

Original languageEnglish (US)
Pages (from-to)699-710
Number of pages12
JournalFoot and Ankle International
Issue number7
StatePublished - Jul 2008
Externally publishedYes


  • Bone metastasis
  • Foot metastasis
  • Foot tumor
  • Secondary foot tumor
  • Skeletal metastasis

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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