Sumulong Martin Carmelo, Coruña Juan Agustin, Liawrungrueang Wongthawat
Department of Orthopaedics and Traumatology, Corazon Locsin Montelibano Memorial Regional Hospital, Bacolod City, Philippines.
Department of Orthopaedics.
Ann Med Surg (Lond). 2023 Apr 11;85(5):2041-2045. doi: 10.1097/MS9.0000000000000568. eCollection 2023 May.
One to ten percent of all squamous carcinomas are invasive squamous cell carcinomas (ISCC), a rare variation of the disease. According to a recent literature review, less than 25 cases have been reported in the foot and ankle, making it especially uncommon in those areas.
The authors present the case of a male patient, 60 years old, who presented with a progressive mass on his left ankle for 2 years with a history of healed burns in that area. The ISCC was diagnosed using histopathology after which he underwent a marginal excision biopsy and split-thickness skin grafting. Wide-marginal excision and split-thickness skin grafting were done. It was noted that the graft had taken well and that there were clear tumour margins postoperatively. The skin graft was almost completely incorporated. No tumour cells were reported on the margins during the postoperative histopathology.
This case highlights a successful outcome of the patient improved at the 12-month follow-up, and he expressed a high degree of satisfaction with the treatment.
ISCC of the lower extremities is a rare disease that almost never affects the ankle and is frequently treated inappropriately since it mimics chronic wounds. It is important to have an index of suspicion in patients with a history of chronic irritation to the area of interest. Surgery is the primary option if ICCS is detected. Clear tumour margins are important, and, if done well, excision should be curative.
所有鳞状细胞癌中有1%至10%为浸润性鳞状细胞癌（ISCC），这是该疾病的一种罕见变体。根据最近的文献综述，足部和踝部报道的病例不到25例，在这些部位尤为罕见。
作者报告了一例60岁男性患者，其左脚踝出现渐进性肿块2年，该区域有烧伤愈合史。通过组织病理学诊断为ISCC，之后他接受了边缘切除活检和中厚皮片移植。进行了广泛边缘切除和中厚皮片移植。注意到移植皮片成活良好，术后肿瘤边缘清晰。皮肤移植几乎完全融合。术后组织病理学检查边缘未报告肿瘤细胞。
该病例突出了患者在12个月随访时病情改善的成功结果，他对治疗表示高度满意。
下肢ISCC是一种罕见疾病，几乎从不累及踝部，且由于其类似慢性伤口，常被不恰当治疗。对于有感兴趣区域慢性刺激史的患者，保持怀疑指数很重要。如果检测到ISCC，手术是主要选择。清晰的肿瘤边缘很重要，如果操作得当，切除应可治愈。
