Metastatic squamous cell carcinoma of the hand and review of the literature.

New cases of cancer amongst medical workers arising as a result of X-ray exposure are now rare. We record a case of a dentist who presented 11 years ago with a radiation induced squamous cell carcinoma of the ring finger of his left hand with massive axillary lymphadenopathy. Repeated exposure of his hands to diagnostic dental irradiation in his surgery had lead 16 years previously to a troublesome radiodermatitis which had been mistakenly diagnosed and had itself been treated with radiotherapy without effect. Management by amputation of the distal phalanx of the ring finger, debulking of the axillary lymphadenopathy with adjunctive radiotherapy to the axilla and chemotherapy, have been successful in achieving a prolonged disease free interval and satisfactory hand function.