Cutaneous SCC: metastases with a predilection for lungs 6 years after excision of the primary tumour

An 80-year-old woman developed an ulcerated, moderately differentiated squamous cell carcinoma (SCC) on the lower leg. Despite local excision and radiotherapy, the patient presented 6 years later with multiple lung metastases which were histologically indistinguishable from the original skin tumour. There was no evidence of metastases to lymph nodes or other viscera.