Bilateral hand squamous-cells carcinoma in patient affected with non-Hodgkin lymphoma. Case report and literature review

Abstract

Background: Squamous-cell skin cancer is the most frequent tumor in the hand. It occurs on sun-damaged skin, especially in lightskinned individuals with a long history of chronic sun exposure.

Case report: We describe a case of bilateral hand squamous-cell carcinoma in a elderly patient affected with non-Hodgkin's lymphoma, who underwent several non-successful surgical treatment, radiotherapy and at the least, amputation of right hand for rapid clinical evolution after radiotreatment. Available literature on the subject has been reviewed.

Results: In our case, after several non-successful treatment, elective amputation at the distal third of forearm was performed. We reviewed 56 items including books, original articles, reviews, cases report.

Conclusions: Current evidence on treatment of hand squamouscells carcinoma is to perform a first radical surgical treatment in order to avoid recurrence/metastasis and to achieve a safer level of amputation thus increasing the surface area of healthy tissue available for eventually subsequent reconstruction/prosthesization.

Fig. 1

Tumor lesion on dorsal surface of right hand (a) infiltrating the palmar region (b).

Fig. 2

Left hand: current clinical pictures (a, b).

Fig. 3

Imaging. a) Hand CT: almost complete osteolysis interesting the distal two thirds of the fourth metacarpal and the base of its proximal phalanx; osteolytic phenomena on the head of the metacarpal III and at the base of its proximal phalanx, too. b) Total body CT, abdominal particular: lymph nodes in the retrocrurale, inter-aorto-caval and left para-aortic areas.

Fig. 4

Post-operative result after amputation at the distal third of the right forearm.