[Metastasis of pulmonary origin in a metatarsal head: differential diagnosis of an attack of gout. Literature review of bony metastases of hands and feet].

The osseous metastasis in our patient's first toe has been the initial clinical manifestation of a pulmonary neoplasm and the clinical picture was that of a gout-attack or an other osteoarticular affection. As a rule, primary supradiaphragmatic neoplasia tend to metastasize to the hands whereas primary infradiaphragmatic neoplasia tends to metastasize to the feet. Our patient, who presented a pulmonary tumor with a metastasis in the right foot, did not fit into this schedule.