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A 45-year-old man with a history of adenocarcinoma in the right lung 3 years ago underwent a 99mTc-MDP bone scan to evaluate possible osseous metastasis. The images demonstrated intense activity in the region of left thumb, while the tracer uptakes in other bones were not typical of metastases. A CT of the hand showed diffuse sclerotic changes with destructed trabecular structure in the proximal phalanx of the left thumb. The left thumb was subsequently resected, and the pathological examination of the resected left first metacarpal bone confirmed the diagnosis of metastasis of lung adenocarcinoma.