Metastatic adenocarcinoma to the distal fibula

This 71-year-old woman presented with atraumatic ankle pain. Her radiographic work-up resulted in the diagnosis of metastatic lung carcinoma to the distal fibula with extensive bony erosion and pathological fracture. Although such cancers may often spread to bone, the locale in the distal fibula is apparently quite rare. An aggressive one-stage treatment of excisional biopsy and application of a cement and screw-plate construct allowed early return to weight-bearing. Such treatment protocol should be considered when the lifespan of these patients may be limited.