{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:39:12Z","timestamp":1761824352409},"reference-count":3,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nAcrometastases, secondary tumors affecting oncological patients with systemic metastases, are associated with a poor prognosis. In rare cases, acrometastases may precede establishing the primary tumor diagnosis.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nA 72-year-old female heavy smoker presented with low back pain, and right lower extremity sciatica\/radiculopathy. X-rays, CT, MR, and PET-CT scans documented primary lung cancer with multi-organ metastases and accompanying pathological fractures involving the sacrum (S1) and right 4th<\/jats:sup> digit. She underwent a S1 laminectomy and amputation of the distal phalanx of the right fourth finger. The histological examination documented a poorly differentiated pulmonary adenocarcinoma infiltrating bone and soft tissues in the respective locations. The patient was treated with a course of systemic immunotherapy (i.e. pembrolizumab). At 6-month follow-up, the patient is doing well and can stand and walk without pain.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nSpontaneous sacral fractures may be readily misdiagnosed as osteoporotic and\/or traumatic lesions. However, in this case, the additional simultaneous presence of a lytic finger lesion raised the suspicion that these were both metastatic tumors. Such acrometastases, as in this case attributed to a lung primary, may indeed involve the spine.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_917_2021","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T08:04:14Z","timestamp":1635149054000},"page":"534","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Spontaneous sacral fracture with associated acrometastasis of the hand"],"prefix":"10.25259","volume":"12","author":[{"given":"Giuseppe Emmanuele","family":"Umana","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Cannizzaro Hospital, Sicily, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Scalia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Highly Specialized Hospital and of National Importance \u201cGaribaldi,\u201d Sicily, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Palmisciano","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cannizzaro Hospital, Sicily, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Passanisi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Highly Specialized Hospital and of National Importance \u201cGaribaldi,\u201d Sicily, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Pompili","sequence":"additional","affiliation":[{"name":"Plastic Surgery Unit, Cannizzaro Hospital, Sicily, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Amico","sequence":"additional","affiliation":[{"name":"Department of Pathological Anatomy, Cannizzaro Hospital, Sicily, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Ippolito","sequence":"additional","affiliation":[{"name":"Department of Advanced Technologies, Nuclear Medicine and PET, Cannizzaro Hospital, Sicily, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Gabriella","family":"Sabini","sequence":"additional","affiliation":[{"name":"Medical Physics Unit, Cannizzaro Hospital, Catania, Sicily, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Cicero","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cannizzaro Hospital, Sicily, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosario","family":"Perrotta","sequence":"additional","affiliation":[{"name":"Plastic Surgery Unit, Cannizzaro Hospital, Sicily, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2021,10,25]]},"reference":[{"key":"10.25259\/SNI_917_2021\/ref-1","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/j.jhsa.2014.01.016","article-title":"Metastases to the hand and wrist: An analysis of 221 cases","volume":"39","author":"Afshar","year":"2014","journal-title":"J Hand Surg Am"},{"key":"10.25259\/SNI_917_2021\/ref-2","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.hcl.2004.03.010","article-title":"The hand in metastatic disease and acral manifestations of paraneoplastic syndromes","volume":"20","author":"Hayden","year":"2004","journal-title":"Hand Clin"},{"key":"10.25259\/SNI_917_2021\/ref-3","doi-asserted-by":"crossref","first-page":"950","DOI":"10.3390\/medicina57090950","article-title":"Acrometastases to the hand: A systematic review","volume":"57","author":"Umana","year":"2021","journal-title":"Medicina (Kaunas)"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/spontaneous-sacral-fracture-with-associated-acrometastasis-of-the-hand\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/spontaneous-sacral-fracture-with-associated-acrometastasis-of-the-hand\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T08:04:19Z","timestamp":1635149059000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/spontaneous-sacral-fracture-with-associated-acrometastasis-of-the-hand\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,25]]},"references-count":3,"alternative-id":["10.25259\/SNI_917_2021"],"URL":"https:\/\/doi.org\/10.25259\/sni_917_2021","relation":{},"ISSN":["2152-7806"],"issn-type":[{"value":"2152-7806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,25]]},"article-number":"534"}}