Increase of serum high-density lipoprotein in phenytoin users.

Abstract

99with metastases of the first metatarsal and proximal phalanx, while Bright and Wilkie4 reported involvement of the talus and four metatarsals by metastatic transitional cell carcinoma.Gall et a12 in their series included a case in which there was involvement of the calcanium, fifth metatarsal, and fifth phalanx by metastatic squamous carcinoma.In our case 11 of the foot bones were partly or completely affected by metastatic carcinoma, this being the first report of such massive metastatic disease of the foot.Although foot pain is very common, this case shows that it may be a presenting sign of occult visceral carcinoma and an initial radiograph of the foot may not show evidence of metastatic carcinoma.We are indebted to Mrs W Jones for secretarial help.