Carcinoma, which has predilection for metastasis to hands and feet bones: March 2007
**Core Concept**
Prostate cancer is a type of adenocarcinoma that originates from the prostate gland. It is known for its tendency to metastasize to bones, particularly those in the axial skeleton. However, an exception to this pattern is seen in prostate cancer metastasis to the bones of the hands and feet, which is a rare but characteristic presentation.
**Why the Correct Answer is Right**
This phenomenon is attributed to the unique vascular supply and bone architecture of the hands and feet. The bones in these regions have a high concentration of red marrow, which is a common site for prostate cancer metastasis. The metastatic cells in the blood flow from the primary tumor site to the red marrow, where they proliferate and form metastatic lesions. The high density of capillaries in the hands and feet also facilitates the delivery of cancer cells to these areas.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not specify the type of cancer that has a predilection for metastasizing to the bones of the hands and feet. While various cancers can metastasize to these regions, prostate cancer is the most well-documented example.
**Option B:** This option is incorrect because it is too vague and does not provide any specific information about the type of cancer or its metastatic pattern.
**Option C:** This option is incorrect because it does not accurately describe the typical metastatic pattern of prostate cancer. While prostate cancer can metastasize to the bones, it typically targets the axial skeleton rather than the bones of the hands and feet.
**Clinical Pearl / High-Yield Fact**
Prostate cancer metastasis to the bones of the hands and feet is a characteristic but rare presentation that should be considered in the differential diagnosis of patients with cancer who present with bone pain or swelling in these regions.
**Correct Answer:** D. Prostate cancer.