BMJ Case Reports 2018; doi:10.1136/bcr-2017-223880
  • Images in…

Arm amputation secondary to squamous cell carcinoma: exotic expeditions leading to a delayed diagnosis?

Editor's Choice
  1. Harry Lewis
  1. Department of Plastic Surgery, South Eastern Health and Social Care Trust, Dundonald, UK
  1. Correspondence to Mr. Kevin McGarry, kmcgarry10{at}
  • Accepted 21 December 2017
  • Published 11 January 2018


Despite squamous cell carcinoma being one of the most common skin cancers in the UK,1 atypical presentations can lead to delayed diagnosis and management. Here, we present a 67-year-old man who had spent a considerable period of his adult life in the Congo as a gold prospector, referred to us by the dermatology team. The man reported an insect bite that had developed into a chronic ulcer of his left forearm sometime in the early 1990s. The ulcer had been managed conservatively for over 15 years in primary care without ever completely resolving; however, over the past year, it had rapidly developed into a large fungating mass encompassing the majority of …

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