A clinical case of a woman with lung cancer and a very painful bone metastases of the phalangette of the 4th finger of the right hand (acrometastases) is described. Palliative radiation on the 4th finger was not indicated due to almost complete bone destruction. Both patient and daughter refused administration of strong opioids, such as morphine, for pain management, due to fear of addiction and of opioid-related adverse effects. Phalangectomy, with palliative intent, was performed under local anaesthesia, in day surgery, resulting in complete pain relief.
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