CASE HISTORY

The patient developed what he thought was a boil on the left buttock. This burst and then gradually got bigger and did not show any signs of healing. Four months after this he came to hospital and he now had a large ulcerating lesion on the left buttock with a raised edge and deep crater. No enlarged lymph nodes. Biopsy showed a squamous carcinoma. At operation the tumour was widely excised but on the deeper aspect a fistula was found going through the anus; this was dissected out and the fistula evacuated and excised. The wound took a good time to heal but did so satisfactorily and up to the end of 1963 the patient remained free from any sign of recurrence, or metastasis.

PATHOLOGY

The specimen consists of pigmented skin with an ulcer in it. The original surgical specimen was larger than this and has been trimmed. The tumour has a raised and obviously nodular edge. It was excavated in the middle. From the lower left border, a piece has been removed for histological examination. On the deeper aspect the fistulous track that ran away to the anus can be seen at the side, and in the middle in the depths of the ulcer tumour can be seen extending through to the cut face but this is an artificial cut face made in the mounted specimen to show the penetration of the tumour. The original surgical specimen contained a good safe margin of tissue beneath the tumour.