A 72-year-old male presented with a painful index finger 18 months after sigmoid colon resection for T2 N1 adenocarcinoma. A presumptive diagnosis of gout was made but directed therapy failed to alleviate symptoms. A bone scan was positive for the index finger only and plain films demonstrated a lytic lesion of the distal phalanx. The patient underwent ray amputation of the involved digit and shortly later resection of a solitary pulmonary nodule consistent with colonic metastasis. At 18-month follow-up from these surgeries, the patient was doing well, without evidence of recurrent disease.
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