Age / Sex : 89 / M

Chief complaint :
수개월 전부터 Left 4th finger 피부 벗겨짐, mass, bleeding
- 타병원 치료에도 호전 없음.

Early gastric cancer s/p subtotal gastrectomy (2018)

What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer)

Courtesy : 이지숙 (Jisook Yi), 해운대 백병원 (Haeundae Paik Hospital)

Squamous cell carcinoma (Marjolin's ulcer)

Discussion

Findings
Approximately 1.5 cm sized well defined soft tissue lesion at dorsal side of cutaneous and subcutaneous fat layer of right nail bed to distal phalanx of 4th finger.
shows subtle high signal intensity on T1 weighted image and heterogenous subtle high signal intensity on T2 weighted image.
with mild homogenous contrast enhancement.
diffusion restriction (+)


References
Juan, Yu-Hsiang, et al. "Malignant skin and subcutaneous neoplasms in adults: multimodality imaging with CT, MRI, and 18F-FDG PET/CT." American Journal of Roentgenology 202.5 (2014): W422-W438.
Yu, Nanze, et al. "Marjolin’s ulcer: a preventable malignancy arising from scars." World journal of surgical oncology 11 (2013): 1-7.