Recurrent brain metastases from cutaneous squamous cell carcinoma of great toe; a case report.
Background: The majority of cutaneous squamous cell carcinoma (SCC) are diagnosed early and cured using local treatment, although a minority of cases metastasize to regional structures. In this report, the authors describe an unknown feature of skin SCC, namely, distant recurrent brain metastasis
Case: 53 years old man with history of arsenicosis developed ulceration of medial side of left great toe. Biopsy showed squamous cell carcinoma, well differentiated. He underwent Ray’s amputation of great toe. FNAC from nodular lesion showed suggestive of malignancy. FNAC from left inguinal region showed metastatic squamous cell carcinoma. Then he received six cycles of chemotherapy with inj cisplatin and inj 5-flurouracil. The lesions were resolved and under follow-up. But again after eight months of chemotherapy he develop headache, vertigo, paresis of lower limb. MRI of brain showed right temporal SOL, suggestive of recurrence. He was then planed for re irradiation to brain. Received 20Gy in10 fractions ( over two weeks using linear accelerator) re irradiation to brain. He is still alive after 6 months of re-irradiation in spite of poor performance status.
Conclusions: Brain metastases in cutenious squamous cell carcinoma is very rare. Although the described case is unique, knowledge of the potential for this uncommon behavior in cutaneous SCC and management may be useful.
