Acrocutaneous metastasis - A rare presentation

Cutaneous metastasis from head and neck cancer is uncommon and it is seen from laryngeal cancer. Acrocutaneous metastasis from the base of tongue is relatively rare.

We present a case of a 84-year-old male, previously diagnosed to have moderately differentiated squamous carcinoma of the base of tongue with lung and liver metastases and received palliative chemoradiation. He, now presented with ulcero-proliferative growth over the right 5th finger. In the present case, the patient initially presented with a nodule which later ulcerated and increased in size. There was associated discharge. There was clinical suspicion of underlying osteomyelitis. Hence right 5th finger amputation upto the middle phalanx was done. The histopathology report of the specimen was moderately differentiated squamous cell carcinoma. This is a case of skin metastasis from squamous carcinoma of the base of Tongue is rare at a short span of time following the completion of treatment. This case has highlighted the probable presence of occult skin metastasis at the time of diagnosis, which became apparent after the completion of treatment.

Fine needle aspiration cytology should be done in cutaneous nodules associated with head and neck cancers to rule out malignancy, even if it clinically appears to be benign in nature.