Location

Virtual

Event Website

https://www.medschool.lsuhsc.edu/genetics/2024_medical_student_research_poster_symposium.aspx

Presentation Date

5-11-2024 12:00 PM

Description

Introduction

Human Papillomavirus (HPV) is the most common sexually transmitted infection globally, affecting approximately 79 million people in the U.S. While often asymptomatic, HPV can cause various lesions and cancers, including periungual warts that may lead to squamous cell carcinoma (SCC). This case report discusses a rare case of such instance.

Methods

The rare case was identified, and the patient consented to participate in the case report as a deidentified individual. All identifying features were removed to maintain anonymity.

Results

A 42-year-old male with cell-mediated immunodeficiency and a long history of disseminated HPV presented with worsening, painful lesions on his hands and feet. His medical history included a failed bone marrow transplant and unsuccessful treatments like intralesional Cidofovir. A multidisciplinary team managed his care, focusing on palliative treatment to alleviate pain and address the risk of malignant transformation. Initial surgery involved amputating the left index and ring fingers and debulking lesions on the left thumb and long finger. Pathology revealed SCC with positive margins, leading to a stage IV SCC diagnosis and initiation of pembrolizumab therapy.

As painful malignant lesions persisted, further surgeries were performed, including the amputation of the right thumb, index, and long fingers, along with excision of lesions on the hand and forearm. The treatment aimed to manage pain, prevent infection, and control cancer spread, with ongoing surgeries to debulk tumors and maintain hand function. Despite positive margins in some resected specimens, palliative debulking and amputations effectively managed symptoms. Ultimately, the final surgical margins were cancer-free following further surgical intervention, suggesting that the combination of palliative surgery and pembrolizumab was effective in controlling the disease. The patient’s amputation sites healed well, with no postsurgical complications, indicating successful management of the patient’s disease.

Conclusion

This case highlights a case of severe stage IV HPV-associated SCC in both hands, where curative treatment was not possible, and underscores the importance of palliative surgery in enhancing the quality of life for patients.

Comments

Mentor: Dr. Kelly L. Babineaux, MD, FACS LSUHSC Department of Surgery, Division of Plastic and Reconstructive Surgery

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Nov 5th, 12:00 PM

Case Report: Surgical Resection and Management of Periungual Human Papilloma-Associated Squamous Cell Carcinoma Lesions Involving Both Hands

Virtual

Introduction

Human Papillomavirus (HPV) is the most common sexually transmitted infection globally, affecting approximately 79 million people in the U.S. While often asymptomatic, HPV can cause various lesions and cancers, including periungual warts that may lead to squamous cell carcinoma (SCC). This case report discusses a rare case of such instance.

Methods

The rare case was identified, and the patient consented to participate in the case report as a deidentified individual. All identifying features were removed to maintain anonymity.

Results

A 42-year-old male with cell-mediated immunodeficiency and a long history of disseminated HPV presented with worsening, painful lesions on his hands and feet. His medical history included a failed bone marrow transplant and unsuccessful treatments like intralesional Cidofovir. A multidisciplinary team managed his care, focusing on palliative treatment to alleviate pain and address the risk of malignant transformation. Initial surgery involved amputating the left index and ring fingers and debulking lesions on the left thumb and long finger. Pathology revealed SCC with positive margins, leading to a stage IV SCC diagnosis and initiation of pembrolizumab therapy.

As painful malignant lesions persisted, further surgeries were performed, including the amputation of the right thumb, index, and long fingers, along with excision of lesions on the hand and forearm. The treatment aimed to manage pain, prevent infection, and control cancer spread, with ongoing surgeries to debulk tumors and maintain hand function. Despite positive margins in some resected specimens, palliative debulking and amputations effectively managed symptoms. Ultimately, the final surgical margins were cancer-free following further surgical intervention, suggesting that the combination of palliative surgery and pembrolizumab was effective in controlling the disease. The patient’s amputation sites healed well, with no postsurgical complications, indicating successful management of the patient’s disease.

Conclusion

This case highlights a case of severe stage IV HPV-associated SCC in both hands, where curative treatment was not possible, and underscores the importance of palliative surgery in enhancing the quality of life for patients.

https://digitalscholar.lsuhsc.edu/sommrd/2024MSRD/Posters/7