Publication: Axillary and elbow lymph node metastasis arising after complete excision of microcystic adnexal carcinoma of a hand: A rare presentation
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Issued Date
2019
Resource Type
File Type
application/pdf
ISSN
22102612
Other identifier(s)
2-s2.0-85073689597
Rights Holder(s)
มหาวิทยาลัยศรีนครินทรวิโรฒ
Bibliographic Citation
International Journal of Surgery Case Reports. Vol 64, (2019), p.154-156
Suggested Citation
Chakrapan Na Ayudhya K., Chakrapan Na Ayudhya V., Tipsuwannakul P., Thongvitokomarn S., Tangsirapat V., Kongon P., Thananon J., Sookpotarom S., Sookpotarom P., Vejchapipat P. Axillary and elbow lymph node metastasis arising after complete excision of microcystic adnexal carcinoma of a hand: A rare presentation. International Journal of Surgery Case Reports. Vol 64, (2019), p.154-156. doi:10.1016/j.ijscr.2019.10.023 Retrieved from: https://hdl.handle.net/20.500.14740/5539
Abstract
Introduction: Microcystic adnexal carcinoma (MAC), a malignant transformation of adnexal structures, constitutes a rare locally aggressive malignancy of skin. Generally, the disease is associated with local invasion and distant metastases are extremely rare. We presented a case of MAC with distant metastasis after adequate wide excision. Presentation of case: A 65-year-old man presented with a scar-like lesion at his left hand's middle finger. As pathologic result from incisional biopsy confirmed MAC, the patient was then treated with ray amputation. Eight years later, there was a presence of scar changes. There was a palpable node at medial epicondyle and presence of enlarged lymph nodes at axilla by imaging with Computed tomography (CT) scan. Following left hand amputation and node dissection at elbow and axillary region, pathologic examination confirmed recurrence and metastasis of MAC. He went through adjuvant radiation with a complete response. At present, two years after surgery, he remains in complete remission. Discussion: The presence of a recurrent MAC with distant lymph node metastasis after primary surgery is rare. The metastatic route as presented with the positive nodes at elbow and axilla could be explained the spreading via lymphatic system. Conclusion: MAC arising at a hand may require wider excision in order to achieve best result. Although this malignancy is a slowly progressive disease, distant metastasis should always be concerned, especially when there are suspicious presentations. CT scan will render more details and make more precise diagnosis in the suspicious situation. © 2019 The Authors
Subject(s)
Adjuvant radiotherapy
Aged
Article
Axilla
Cancer recurrence
Cancer regression
Cancer surgery
Carcinoma
Case report
Clinical article
Distant metastasis
Elbow
Hand amputation
Human
Lymph node dissection
Lymph node metastasis
Male
Microcystic adnexal carcinoma of a hand
Priority journal
Treatment response
Wide excision
X-ray computed tomography
Aged
Article
Axilla
Cancer recurrence
Cancer regression
Cancer surgery
Carcinoma
Case report
Clinical article
Distant metastasis
Elbow
Hand amputation
Human
Lymph node dissection
Lymph node metastasis
Male
Microcystic adnexal carcinoma of a hand
Priority journal
Treatment response
Wide excision
X-ray computed tomography