Management of high-risk squamous cell carcinoma of the skin

The Dermatology Centre, Salford Royal Hospital NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.
Expert Review of Anti-infective Therapy (Impact Factor: 2.25). 05/2011; 11(5):763-9. DOI: 10.1586/era.11.36
Source: PubMed


Cutaneous squamous cell cancer (SCC) is the second most common skin cancer, accounting for one-fifth of all cutaneous malignancies. The majority arise on the head and neck skin, and cumulative UV exposure is thought to be the most likely etiological factor. The majority of deaths from SCC occur in a high-risk subgroup of patients. This high-risk subgroup of patients can be identified as those with tumors greater than 2 cm in diameter; tumor thickness over 4 mm; moderately/poorly differentiated or desmoplastic histological SCC subtype; ear, lip, hand, feet or genital tumor site; presence of perineural or lymphovascular invasion; nodal metastasis at presentation; recurrent SCC; SCC arising from scars or chronic skin disease, for example, chronic ulcers; and SCC arising in immunosuppressed patients. It is important to identify and aggressively treat these patients, as high-risk SCC are associated with a greater mortality and morbidity. This article reviews the diagnosis and management of such high-risk SCC.

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    • "SCC is the second-most prevalent cancer of the skin—it is more common than basal cell carcinoma and less common than melanoma.6 Unlike basal cell carcinoma, SCC is associated with a low substantial risk of metastasis.6 The histopathological presentation of SCC varies from scaly erythematous plaques or cutaneous horns to crusted ulcerated lesions.7 "
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    ABSTRACT: Skin cancer formation is on the rise. Only a few case reports, which focus on skin cancer being caused by tattoos, have been published so far. Our aim is to determine whether skin cancer occurrence can be triggered by tattoos. In our presented case, a squamous-cell carcinoma developed inside of the red areas of a multicolored tattoo within months. Furthermore, surgical removal of the cancerously mutated skin area without mutilating the design of the tattoo was challenging. Due to widespread skin alterations in other red areas of the tattoo, those affected skin regions were surgically removed and split-skin grafting was performed. After 1-year follow-up period, the patient has been tumor free. Squamous-cell carcinoma is an unusual reaction that can occur in tattoos. Nevertheless, this skin cancer should be included in the list of cutaneous complications related to tattooing.
    03/2014; 2(2014). DOI:10.1097/GOX.0000000000000055
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    • "In future studies, we aim to investigate CD10 expression in SCC groups of low and high risk according to the degree of differentiation, size, and depth of invasion (perineurial and lymphovascular invasion).18 CD10 expression will be compared between these groups. "
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    ABSTRACT: Background: In addition to the well-defined histological criteria for squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), immunohistochemical techniques can be used in difficult cases for their differentiation. As differential diagnosis between trichoepithelioma (TE) and BCC is sometimes difficult for the clinician and the pathologist, CD10 may be a useful marker for definite diagnosis. We aimed to evaluate the usefulness of this marker in the differentiation between SCC and BCC and also in the differentiation between BCC and TE. Methods: Fifty-five BCC cases, 50 SCC cases, and 20 cases of benign adnexal tumor with follicular differentiation were retrieved from the archives of the pathology departments of hospitals affiliated with Shiraz University of Medical Sciences. Immunohistochemistry for CD10 was performed on the sections obtained from formalin-fixed, paraffin-embedded blocks. CD10 immunoreactivity in the stroma and/or tumor cells was determined as follows: negative (0); 1+(10-50% positive cells); and 2+(>50% positive cells). Results: Comparison of CD10 expression between the BCC and SCC groups showed a significant difference (P<0.001) in each of the tumor and stromal cells. Comparison of CD10 expression between the BCC and TE groups demonstrated a significant difference in both the tumor and stromal cells (P<0.001). There was no significant difference in CD10 expression between the stromal and tumor cells of the BCC subtypes. Conclusion: CD10 is a useful adjunct marker in distinguishing TE from BCC. CD10 is suggested to be one of the useful immunohistochemical markers to differentiate BCC from SCC.
    Iranian Journal of Medical Sciences 06/2013; 38(2):100-6.
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    • "Non-well differentiated SCCs have been reported as deeper tumors [3] with greater recurrence rates [3,4]. Poorly differentiated SCC on the ear or mucosal lip has an increased risk of metastasis [4,5]. Differentiation grade in SCC has been stated as an independent adjusted predictor for overall survival [6]. "
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    ABSTRACT: Compare the dermatoscopy vascular features of well differentiated with non-well differentiated squamous cell carcinoma (SCC). A prospective study of 294 consecutive cases of histopathologically confirmed invasive SCC compared the dermatoscopic vascular features of well to combined moderate and poorly differentiated tumors. These features were recorded live directly from the patients and included: the percentage of pink in the tumor, the presence of branching, serpentine, dot, hairpin, glomerular and linear vessels, and the number of these vessel types present within each tumor. Vessel types were also reviewed by tumor depth in 1 mm increments. Two medical practices in Sydney, Australia. Eighty-six female and 208 male patients (29-95 years old). Dermatoscopic vascular feature variation between grades of tumor differentiation and tumor depth. Of 294 invasive SCCs, 255 (87%) were well differentiated, 32 (11%) were moderately differentiated and 7 (2%) were poorly differentiated. The percentage of pink areas within tumors varied between differentiation grades. The combined group of moderate and poorly differentiated tumors displayed more branching (28%, P<0.001) and serpentine (62%, P<0.005) blood vessels compared to well differentiated tumors (8% and 38%, respectively). Moderate and poorly differentiated tumors displayed larger numbers of vessel types (3.3) compared to well differentiated tumors (2.6, P < 0.01). Branching and serpentine vessels both increased in incidence with increasing tumor depth (p<0.05). Grades of tumor differentiation in SCC display varying dermatoscopic vascular features. The incidence of branching and serpentine vessels increases with increasing tumor depth and the shift towards poor differentiation.
    10/2012; 2(4):204a05. DOI:10.5826/dpc.0204a05
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