Squamous Cell Carcinoma in Background of Chronic Lymphedema Secondary to Filariasis: A Rare Entity

Abstract

Abstract:Filariasis, a parasitic infection caused by Wuchereria brancrofti, is common in Northern India and most common cause of secondary lymphedema. Dreaded complication of chronic lymphedema is lymphangiosarcoma. In our case, prolonged standing elephantiasis for about 2 decades leads to development of squamous cell carcinoma. Squamous cell carcinoma is a potentially lethal entity and awareness of association can lead to early intervention. We will discuss the management and possible pathogenesis of this unusual case.

Squamous cell carcinoma of skin in a case of post-filariasis chronic lower limb lymphedema- a case study and review of literature

“…[ 2 , [13] , [14] , [15] , [16] , 20 ]. Above knee amputation with inguinal lymph node dissection and adjuvant loco-regional radiation was required in a case of post-filarial lymphedema and SCC presenting with multiple ulcerations [ 17 ]. Above knee amputation was required in another case of non-healing ulcers of the foot with long-standing congenital lymphedema nonresponsive to multiple treatments [ 11 ].…”

Postamputation diagnosis of squamous cell carcinoma in a patient with lymphedema

“…To date, 11 cases of SCC of a lower extremity affected by lymphedema have been reported ( Table ). 4 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 A congenital etiology of lymphedema was most common (36%), followed by post-traumatic (27%) and postfilarial (18%). The majority of these cases (64%) were treated with local excision with or without skin grafting of the defect.…”

“… 4 , 16 , 17 , 18 , 19 , 20 Pedal amputation was required in a case of SCC in a patient with lymphedema and underlying epidermodysplasia verruciformis, with extensive involvement of the distal foot. 21 Above-the-knee amputation was required in a case of postfilarial lymphedema and SCC presenting with multiple ulcerations and wet gangrene who had been nonambulatory before presentation, 15 as well as in a case of nonhealing ulcers of the foot with long-standing lymphedema nonresponsive to multiple treatments. 22 One case 15 received postoperative locoregional radiation therapy owing to spread to the inguinal lymph nodes.…”

“… 21 Above-the-knee amputation was required in a case of postfilarial lymphedema and SCC presenting with multiple ulcerations and wet gangrene who had been nonambulatory before presentation, 15 as well as in a case of nonhealing ulcers of the foot with long-standing lymphedema nonresponsive to multiple treatments. 22 One case 15 received postoperative locoregional radiation therapy owing to spread to the inguinal lymph nodes. Chemotherapy was not used in any of these cases, likely owing to the nonmetastatic nature of the remaining reported cases.…”