Carcinoma Espinocelular cutâneo bem diferenciado: apresentação atípica

CARNEIRO, Vinícius Figueiredo; FIGUEIREDO, Carolina Lamac; SOARES, Paula Grisolia Oliveira Netto; CARVALHO, Erlon de Ávila; FERREIRA, Karina Noman; JÚNIOR, Walter Ferraz Flávio; MOREIRA, Reni Cecília Lopes; MIYATA, Seiji; CINTRA, Cássio Andrade
August 2012
Revista da Universidade Vale do Rio Verde;ago-dez2012, Vol. 10 Issue 2, p52
Academic Journal
Nonmelanoma skin câncer is the most common malignant tumor in Brazil. Its less common subtype, squamous cell carcinoma (SCC), can be aggressive, but it's usually completely healed with only local tharepeutic measures. The case reported is about a 75 year-old woman who had a 2,5 cm lesion on the back of the left hand diagnosed as welldifferentiated SCC. She was submitted to a resection of the tumor with surgical margins of 1,5 cm. After 75 days of surgery, the patient returned with enlarged left axillary lymph node. Biopsy was done, which concluded that it was metastatic well-differentiated SCC. The treatment proposed was axillary lymphadenectomy associated with adjuvant radiation therapy. The patient presented axillary tumor recurrence and severe local pain, being submitted to extended local resection. It was proposed to the patient the interscapulothoracic disarticulation surgery and the patient agreed to the procedure. Currently, the patient is in outpatient control, with no signs of recurrence or distant metastasis. This case shows an atypical presentation of well-differentiated SCC with the primary tumor on the back of the left hand and an axillary lymph node metastasis, with compromised quality of life. The interescapulothoracic disarticulation surgery was the treatment proposed due to the presence of a tumor locally advanced, nonfunctionality of the member, the possibility of better local hygiene and absence of metastasis at other sites.


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