Speaker Credentials
MS-II
Speaker Credentials
BS
College
College of Allopathic Medicine
Medical Specialty
Dermatology
Format
Poster
Start Date
November 2024
End Date
November 2024
Track
3
Abstract
INTRODUCTION Squamous cell carcinoma (SCC), a malignant skin tumor, is commonly associated with osteomyelitis. Although an unusual occurrence, it is speculated that the tumor can spread along the tendon sheaths of the hand. The risk of malignant transformation is considerably increased in patients with a history of amputation. This may necessitate additional screening, amputation, or surgical repair of the defect. CASE PRESENTATION We present a patient with a progressively enlarging mass in his left hand following a prior finger amputation, which was later diagnosed as invasive SCC with concurrent osteomyelitis. Initial surgery involved mass excision and ray amputation of the second and third metacarpals, but positive margins required further amputation at the carpometacarpal joint level. OUTCOMES A PET scan revealed hypermetabolic lymph nodes, though core biopsy confirmed the absence of malignancy in the lymphatic tissue. No abnormal PET uptake was detected in other bodily tissues. DISCUSSION In complex hand SCC cases, misdiagnosis as benign conditions such as inflammation or cellulitis can delay treatment and allow the tumor to progress, sometimes spreading along tendon sheaths. Risk factors like chronic inflammation, prior trauma, amputation, or osteomyelitis increase the likelihood of skin cancer, necessitating careful evaluation. Early biopsy is crucial in patients with persistent lesions to rule out malignancy and prevent severe outcomes such as amputation. Though SCC metastasis in the hand is rare, it can spread through flexor tendon sheaths, warranting a thorough workup in complicated cases. Selective lymphadenectomy may help prevent further malignancy in high-risk patients but requires careful consideration of risks and benefits.
Included in
Invasive Squamous Cell Carcinoma Arising After Digit Amputation: A Case Study
INTRODUCTION Squamous cell carcinoma (SCC), a malignant skin tumor, is commonly associated with osteomyelitis. Although an unusual occurrence, it is speculated that the tumor can spread along the tendon sheaths of the hand. The risk of malignant transformation is considerably increased in patients with a history of amputation. This may necessitate additional screening, amputation, or surgical repair of the defect. CASE PRESENTATION We present a patient with a progressively enlarging mass in his left hand following a prior finger amputation, which was later diagnosed as invasive SCC with concurrent osteomyelitis. Initial surgery involved mass excision and ray amputation of the second and third metacarpals, but positive margins required further amputation at the carpometacarpal joint level. OUTCOMES A PET scan revealed hypermetabolic lymph nodes, though core biopsy confirmed the absence of malignancy in the lymphatic tissue. No abnormal PET uptake was detected in other bodily tissues. DISCUSSION In complex hand SCC cases, misdiagnosis as benign conditions such as inflammation or cellulitis can delay treatment and allow the tumor to progress, sometimes spreading along tendon sheaths. Risk factors like chronic inflammation, prior trauma, amputation, or osteomyelitis increase the likelihood of skin cancer, necessitating careful evaluation. Early biopsy is crucial in patients with persistent lesions to rule out malignancy and prevent severe outcomes such as amputation. Though SCC metastasis in the hand is rare, it can spread through flexor tendon sheaths, warranting a thorough workup in complicated cases. Selective lymphadenectomy may help prevent further malignancy in high-risk patients but requires careful consideration of risks and benefits.