Pathologic Tuft Fracture in a Thumb: A Rare Presentation of Metastatic Endometrioid Ovarian Carcinoma: A Case Report and Review of the Literature.

Case: A 51-year-old woman with a medical history noteworthy for endometrioid ovarian carcinoma presented with progressive left thumb swelling in the absence of trauma or injury. Radiographs revealed a lytic lesion in the distal phalanx. Inflammatory markers and white blood-cell count were mildly elevated. The thumb was amputated at the interphalangeal joint, and pathologic examination identified the lesion as an adenocarcinoma, consistent with the known endometrioid ovarian carcinoma.

Conclusion: The similar presentation of tumor and infection can present a diagnostic challenge. Despite the rare incidence of osseous metastases to the hand, orthopaedic surgeons must consider metastatic bone lesions in patients presenting with swollen or painful fingers.