Multiple Primary Cutaneous Squamous Cell Carcinomas of the Extremities-Case Report

Abstract

Multiple primary cutaneous squamous cell carcinomas (CSCCs) are common in the head and neck region, but synchronous CSCCs of the extremities have not been frequently reported in the literature. Multiple CSCCs carry a high risk of subsequent primary skin cancer. CSCCs arising in a scar have higher rate of recurrence or metastasis than those occurring in actinic keratoses. A patient presented with primary CSCCs on the ankle and wrist. She had a 14-year history of a scar on her ankle which became ulcerated 2 years prior to presentation, as well a numerous cancer precursors on her palms, fingers, and extremities that had been investigated several years earlier. Although the ankle lesion was consistent with Marjolin's ulcer, the synchronous wrist lesion and multiple precancerous lesions raise the possibility of other etiologies, including cancer arising in actinic keratoses and/or chronic arsenism.