PMC5512023_01
Plain radiographs of the left foot show destruction of the first distal phalanx.
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Radiographs also showed irregular osteolysis in the cortices of his left distal tibia and fibula, which strongly indicated bone metastases (Figures 1 and 2).
Plain radiographs of right distal ulna and the left lower leg show irregular osteolysis.
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Radiographs also showed irregular osteolysis in the cortices of his left distal tibia and fibula, which strongly indicated bone metastases (Figures 1 and 2).
T1-weighted magnetic resonance imaging of the left foot shows low intensity in the first distal phalanx.
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On foot magnetic resonance images, bone metastasis of the left big toe was observed spreading across the distal phalanx (Figure 3).
Photograph of the left foot. Subungual hemorrhage from the metastasis, which required a change of dressing on a daily basis, was observed.
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As we considered that it would be difficult to control hemorrhaging with radiation therapy alone (Figure 4), we dissected the distal phalanx.