[Blue toe syndrome as an initial manifestation of metastatic prostate cancer : A case report with literature review].

Rev Med Interne

Service de médecine vasculaire, groupe hospitalier Paris Saint-Joseph, 184, rue Raymond-Losserand, 75014 Paris, France.

Published: September 2022

AI Article Synopsis

  • A case study reports a rare instance of blue toe syndrome as an initial sign of prostate cancer in a 56-year-old man who also experienced Raynaud's phenomenon.
  • The patient had blue discoloration in four toes without ulcers, and while normal vascular and cardiac tests were conducted, an elevated PSA level led to prostate biopsy confirmation of cancer with bone and lymph node metastasis.
  • This case emphasizes the importance of considering cancer in patients presenting with blue toe syndrome and undiagnosed vascular issues, as it can be an atypical manifestation of underlying malignancy.

Article Abstract

Introduction: Cutaneous and vascular manifestations of cancer are numerous. Among paraneoplastic acral vascular syndrome, we report a case of blue toe syndrome as the first manifestation of a prostate cancer following with analysis of this syndrome according literature.

Observation: A 56-year-old man, with Raynaud's phenomenon of the upper limbs for 2 to 3 years, had 4 blue toes of the left foot evolving for 18 months, without ulceration, the pulses being present. Vascular and cardiac explorations (ultrasound, angio-MRI) were normal. There was no biological or immunological abnormality except an elevated PSA level. Prostate biopsies confirmed diagnosis and abdomino-pelvic CT scan proved the bone and lymph node metastasis.

Conclusion: The revelation of a prostate cancer with bone metastases by a blue toe syndrome is a rare situation. In a patient with a blue toe syndrome with no obvious clinical or biological abnormality, especially atheromatous, investigations should include a search for cancer, which can be revealed by blue toes.

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Source
http://dx.doi.org/10.1016/j.revmed.2022.04.017DOI Listing

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