Triceps paralysis with intact distal radial nerve function in partial brachial plexus injury: a unique presentation

The patient was referred to oncology. A PET/CT FDG scan detected no pathological finding. As in the previous patient, no further treatment was planned by the oncology team apart from regular follow-up. ALK1-negative PC-ALCL is a difficult diagnosis to make (Gupta et al., 2022). It is rare and grossly undistinguishable from other skin tumours like squamous cell carcinoma. ALK1-negative PC-ALCL is a disease seen in the elderly age group, as were both of our patients. These tumours grew aggressively and rapidly in both patients, and the provisional clinical diagnosis were incorrect in both. A biopsy was not performed in either patient. Fortunately, in both our patients the surgical excision was carried out without delay and histology identified the correct diagnosis. Based on our experience, the diagnosis of PC-ALCL should be considered when atypical skin lesions of the hand are noted in older people. Such lesion should be biopsied immediately and sent for pathology. In our patients, the absence of prior mycosis fungoides history, the rapid tumour growth and the negative imaging studies all supported the diagnosis of ALK1-negative PC-ALCL.