Park Hyun Chul, Kwon Hyoung Il, Kim Hyun Woo, Kim Jeong Eun, Ro Young Suck, Ko Joo Yeon
Department of Dermatology, Hanyang University Hospital, College of Medicine, Hanyang University, Seoul, Korea.
Am J Dermatopathol. 2016 Feb;38(2):e18-21. doi: 10.1097/DAD.0000000000000412.
Although squamous cell carcinoma (SCC) is the second most common nonmelanoma skin cancer, clinicians have difficulty diagnosing SCC of the toe because its clinical features can mimic other less serious diseases. Clinicians are especially prone to misdiagnose SCC of the toe as diabetic foot ulcer in patients with diabetes mellitus because of the clinical similarity of the 2 ailments. SCC of the toe is generally considered to have a low risk of metastasis. Locoregional or distant metastases without bone or tendon involvement are particularly rare. The authors report here an interesting case of rapidly spreading SCC of the toe with metastasis to multiple lymph nodes and cancer-related lymphedema. Physicians should be aware of the possibility of malignancy when they encounter chronic and recalcitrant ulcerative lesions of the digits.
尽管鳞状细胞癌(SCC)是第二常见的非黑色素瘤皮肤癌,但临床医生在诊断脚趾部的鳞状细胞癌时存在困难,因为其临床特征可能与其他不太严重的疾病相似。由于这两种疾病在临床上有相似之处,临床医生尤其容易将糖尿病患者脚趾部的鳞状细胞癌误诊为糖尿病足溃疡。脚趾部的鳞状细胞癌通常被认为转移风险较低。局部或远处转移而无骨骼或肌腱受累的情况尤为罕见。作者在此报告一例有趣的病例,即脚趾部鳞状细胞癌迅速扩散并转移至多个淋巴结以及出现癌症相关的淋巴水肿。当医生遇到手指或脚趾的慢性顽固性溃疡性病变时,应意识到存在恶性肿瘤的可能性。