Case 1. An 84-year-old female presented with a 5 year history of a fungating lesion on the dorsum of her right hand. The lesion was large and fixation to underlying structures was reported; no axillary lymphadenopathy was present. A biopsy, not unexpectedly reported a poorly differentiated, 13.7mm thick SCC and MRI revealed extensive involvement of the second and third metacarpals and interossei which extended volarly. CT chest, abdomen and pelvis showed no evidence of metastatic spread. Following MDT and patient discussion a distal forearm amputation was undertaken. Recovery was unremarkable and there has been no recurrence or metastatic spread since last clinical review at 48 months ().
Case 3. A 67-year-old male was referred by a Dermatologist with a 2-month history of biopsy proven squamous cell carcinoma present on each hand. The lesion on the right hand involved the middle finger and third webspace and the lesion on the left hand involved only the dorsum. There was no sign of axillary lymphadenopathy bilaterally. This gentleman suffered from COPD, had a tracheostomy in situ for previous T4 vocal cord tumour and was a heavy smoker.\nHe underwent amputation of the right middle and ring fingers at the level of the MCPJ and was reconstructed using a fillet flap from ring finger. Histology reported a moderately differentiated, 17 mm thick SCC. His recovery was unmarkable and recurrence was not detected within the first post-operative year. Unfortunately, he died following sequelae of the vocal cord tumour ().