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October 1989

Carcinoma Cuniculatum of the Hand

Author Affiliations

Henry Ford Hosptial, Detroit, Mich

Arch Dermatol. 1989;125(10):1335-1336. doi:10.1001/archderm.1989.01670220031004

REPORT OF A CASE  Thirteen months prior to seeking our care, a 70-year-old man underwent surgery for a lesion of the left hand that was diagnosed as squamous cell carcinoma (SCC). A 3.2 × 2.0-cm indurated, ulcerated plaque of the left palm in the hypothenar eminence was surrounded by a 5.4 × 4.9-cm area of erythema (Fig 1). The plaque was not adherent to the underlying fifth metacarpal bone. The ulcer discharged a greasy, serosanguineous exudate. There was no palpable axillary lymphadenopathy; however, a left epitrochlear node was palpable and soft. This was felt to be due to reactive hyperplasia.A biospy to adequate depth of the subcutaneous adipose tissue showed deeply invaginating strands of atypical keratinocytes, some of which had central crypts containing keratinous debris (Figs 2 and 3).

DIAGNOSIS:  Carcinoma cuniculatum recurrent after a previous surgical procedure.

THERAPEUTIC CHALLENGE  In this location, on the palm of

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