Case 2. A 71-year-old female was referred from Dermatology with a 5-month history of a fixated swelling on the right index finger and an ulcerated lesion involving the second webspace; a biopsy showed this to be a well differentiated SCC. There was no clinical or radiological evidence of lymphatic or metastatic spread. The patient underwent amputation of the right index finger at the level of the metacarpal phalangeal joint (MCPJ) under general anaesthesia. Histological analysis reported a completely excised moderately differentiated SCC measuring 9.9mm thick. She was discharged home the same day and 48 months later has had no sign of recurrence or metastasis ().
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 ().