Metastatic tumors to the hand are rare and usually involve the distal phalanx; thus, they can be confused with a pulp space infection or felon. Radiographs are useful in differentiating a tumor from infection. Primary lung tumors are the most common metastatic lesion to the hand. Other tumors include breast, kidney, colon, thyroid, and prostate. The photograph shows a case of metastatic renal cell carcinoma. The corresponding radiograph shows almost complete destruction of the distal phalanx.
