Metastasis distal to the elbows and knees, defined as acrometastasis, is rare and generally occurs in bone. We present a review of the management of this entity based on the case of a patient with metastatic testicular cancer who received chemotherapy. At the control of the ninth month, he presented a tumor in the fifth finger, the biopsy was choriocarcinoma. He received second chemotherapy and rescue surgery with negative pathology for malignancy. One month later, he presented brain metastasis and died. Acrometastasis is associated with disseminated disease and a poor prognosis. We have not found reports of testicular primary.