# Squamous Cell Carcinoma of the Thumb With Bone Invasion: A Case Report

## TL;DR

A man developed squamous cell carcinoma on his thumb years after an injury, requiring surgery and highlighting the importance of early diagnosis.

## Contribution

This case report highlights SCC in post-traumatic lesions and emphasizes the need for accurate diagnosis to avoid mismanagement.

## Key findings

- SCC on the thumb was misdiagnosed as osteomyelitis before confirmation via biopsy.
- Proximal phalanx amputation and sentinel lymph node biopsy were performed with no recurrence after four years.
- SCC of the hand has higher recurrence and metastasis rates, requiring surgical margins of at least 1 cm for larger tumors.

## Abstract

This report describes the case of a 57-year-old man who developed squamous cell carcinoma (SCC) on his right thumb 10 years after a traumatic injury. The lesion, initially misdiagnosed as osteomyelitis, persisted despite antibiotic treatment. We suspected a neoplasm, such as a Marjolin's ulcer, which is an SCC that develops long after trauma, including burn scars, and we therefore performed a biopsy of the lesion. A biopsy confirmed SCC with bone invasion but no vascular involvement. The patient underwent a proximal phalanx amputation and ipsilateral axillary sentinel lymph node biopsy (SLNB), which was negative. SCC of the hand has a higher rate of recurrence and metastasis than other sites, emphasizing the need for early diagnosis and appropriate treatment. Delayed detection, as in this case, may lead to more aggressive interventions. Surgical margins of at least 1 cm are recommended for tumors larger than 2 cm in diameter. SLNB can aid in prognostication. Physicians should be aware of the potential for SCC in post-traumatic lesions to avoid misdiagnosis and ensure timely intervention to improve patient outcomes. No recurrence was observed four years after surgery.