再発転移した手の放射線皮膚障害

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We reported a case of recurrent radiationinduced squamous cell carcinoma of theright ring finger of a 65-yearold orthopedist. He received his first amputation inanother hospital in 1989. One year later, recurrence on the stump occured and digitalray amputation was performed in July, 1992. But four months later recurrence on thefourth metacarpal region of the dorsal side was noticed. In May, 1993, we completelyremoved this tumor and dissected axillary lymph nodes after continuous cutaneousinfusion of PEP at a total dose of 50mg. Three months after surgery, epitrochlearlymph nodes metastases ocurred. Radiotherapy only was performed because thepatient refused amputation of the right upper arm. The treatment was not radical.It is difficult to decide to amputate the upper arm, taking into consideration of thequality of life of the patient. But amputation of the upper arm and dissection ofaxillary lymph nodes for a recurrent tumor of a hand would be a better treatment.