The case of a patient with lung cancer is presented whose fi rst metastasis was detected in the 5th metacarpal head. Hand metastasis in lung cancer is a rarity in literature. After the detection of the hand tumor treatment was sidetracked by representatives of other medical specialities. The growing tumor destroyed the 3rd, 4th and 5th metacarpals, thus based on DSA, MRI, CT, PET-CT and X-ray results and thorough planning of the surgical procedures only opposition and grip of thumb and index fi nger was possible to form. During surgery unexpected diffi culties occured partly because of the condtion of tissues, partly because the tumor was infected. It was not possible to plan exactly before the procedure due to the nature of the tumor, and according to the hystological results, the metastasis was cleared only by 6 mm. It was possible to rescue the 2nd metacarpal with the atypical insertion of an AO-plate, so that the fi nal statics of the hand was secured. The postoperative period proved to be reassuring, however due to the quick progression of the underlying disease the patient was lost.

DOI: 10.17489/biohun/2010/1/28