Abstract
A 88-year-old Japanese fisherman was referred to us with a nodule on his dorsum of the left hand with a history of 2 years. Histological examination revealed that well differentiated tumor cells with atypical nuclei invading through the almost entire dermis. Acantholysis as well as horn pearls were scattered within the tumor. Tumor was diagnosed as an actinic keratosis-derived squamous cell carcinoma (AK-SCC), T2N0M0, Stage II. Wide excision with 2 to 3cm margins was carried out for the primary tumor. Ten months later, a swelling of the axillary lymph node appeared, followed by pulmonary metastasis. The patient died about 2 years after the operation for the primary tumor.Despite for the small size of tumor, AK-SCC on the dorsum of hand seems to develop easily metastasis into the axillary lymph node and the lung.
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