Abstract
In June 2000, a 66-year-old Japanese man was admitted to our hospital because of an ulcerative tumor on the back of his left middle finger, and two subcutaneous tumors on the left arm, which showed remarkable edema. A large amount of serous exudate flowed out of the subcutaneous tumor on the upper arm after incision.
Histopathologically, a diagnosis of squamous cell carcinoma (SCC) was made for the tumor on the finger, and metastatic SCC for the two subcutaneous tumors.
His left arm was amputated below his shoulder, and his left axillary and subclavian lymph nodes were dissected. He was treated with combination chemotherapy including cisplatin and 5-fluorouracil 4 times. The histological examination confirmed that the tumor cells had grown in the deep dermis of a part of the dissected skin with normal appearance, representing the presence of intransit metastasis. At present there is no evidence of recurrence, or metastasis to the other organs.
To our knowledge, there are few reported cases in which SCC originating from the skin developed intransit metastasis. The present case strongly suggests that the remarkable lymphedema of his left arm caused local immunodeficiency, and resulted in the rapid induction of the intransit metastasis. [Skin Cancer (Japan) 2002; 17: 75-78]
