Squamous Cell Carcinoma Flashcards
The second most common form of skin cancer is squamous cell carcinoma in the UK. What is the annual incidence of squamous cell carcinoma each year?
1 - 80
2 - 8000
3 - 80,000
4 - 800,000
3 - 80,000
- 4.7% increase in incidence between 2013-2019
Are the number of deaths associated with squamous cell carcinoma going up or down?
- up
- increase of 40% in last 10 years
- people are living longer, which may explain these changes
The second most common form of skin cancer is squamous cell carcinoma in the UK. Where do they most commonly affect?
1 - legs and arms
2 - head and back
3 - head and neck
4 - legs and face
3 - head and neck
- specifically more common on the mouth and ears
- linked to Cumulative UV exposure
Which layer of the skin do squamous cell cancers typically originate from?
1 - melanocytes
2 - keratinocytes
3 - merkel cells
4 - basal cells
2 - keratinocytes
Which of the following mutations in keratinocytes is associated with squamous cell carcinomas?
1 - APC
2 - BRAF
3 - P53
4 - PTCH
3 - P53
Which of the following is NOT a risk factor for squamous cell carcinoma?
1 - Ultraviolet radiation
2 - Immunosuppression
3 - Fairer skin
4 - Solid organ transplant
5 - Increasing age
6 - Female sex
7 - Ionising radiation
8 - Sites of chronic inflammation
6 - Female sex
Being male is a risk factor for SCC
Which of the following skin cancers is most common in patients with Fitzpatrick skin types V and VI?
1 - basal cell carcinoma
2 - squamous cell carcinoma
3 - malignant melanoma
2 - squamous cell carcinoma
Of the 4 images below, which is a squamous cell carcinoma?
- top right
Which of the following is NOT a key feature of a squamous cell carcinoma?
1 - Firm to palpate (may be nodular/plaque-like)
2 - May ulcerate and bleed
3 - May be tender/painful
4 - Has telangiectasia
5 - May have a crusty (keratotic) top with a nodular base
4 - Has telangiectasia
These are common in basal cell carcinomas
Can squamous cell carcinomas be painful?
- yes
- this is how to distinguish between SCC and BCC
Do squamous or basal cell carcinomas grow more aggressively?
- squamous cell carcinomas
Is bowens disease malignant?
- yes
Referred to as squamous cell carcinoma in situ
Part of a spectrum before the development of SCC
Is actinic keratosis cancerous?
- no
These are pre-cancerous cells
Part of a spectrum before the development of SCC
Squamous cell carcinomas (SCC) can grow aggressively. Which of the following is NOT a high risk for SCC that needs treating quickly?
1 - Mouth, ears
2 - <2cm diameter
3 - Moderate – poor differentiation
4 - Immunosuppressed
5 - Invading beyond dermis
2 - <2cm diameter
- typically anything >2cm is worrying
Do patients who are immunocompromised have an increased or decreased risk of skin cancer?
- increased risk
- must wear sun cream even in winter
Especially those patients who have had a solid tumour transplant
Excision is the main stay of treatment in patients with squamous cell carcinoma. What is a typical margin that is aimed for?
1 - 1-2mm
2 - 4-6mm
3 - 8-12mm
4 - 10-20mm
2 - 4-6mm
- depends on the location and risk
- radiotherapy is typically used as an adjunct rather than alone if unable to completely excise
What is the ONLY modifiable risk factor for skin cancer?
1 - sun exposure
2 - weight
3 - immunotherapy
4 - smoking
1 - sun exposure
Avoiding peak UV times can help mitigate the risks associated with skin cancer. What are peak UV times?
1 - 9am - 1pm
2 - 11am - 12pm
3 - 11am - 3pm
4 - 1-3pm
3 - 11am - 3pm
Which of the following are ways to minimise UV exposure and reduce the risk of skin cancer?
1 - Wear hats, sun glasses, clothes
2 - Sunscreen on face and as needed elsewhere
3 - Broad spectrum of >SPF30
4 - Suncream containing UVA: 4-5 stars
5 - all of the above
5 - all of the above
Which 2 of the following can be used for bowens disease, also referred to as SCC in situ?
1 - cryotherapy
2 - topical 5-fluorouracil
3 - Mohs micrographic surgery
4 - radiotherapy and chemotherapy
1 - cryotherapy
2 - topical 5-fluorouracil
Which of the following can be used to treat SCC?
1 - cryotherapy
2 - topical 5-fluorouracil
3 - Mohs micrographic surgery
4 - radiotherapy and chemotherapy
3 - Mohs micrographic surgery
If metastic disease is present, this would most likley be surgery, then chemotherapy and radiotherapy
A 47-year-old woman is seen in the Nephrology clinic as part of her follow-up for end-stage renal failure secondary to autosomal dominant polycystic kidney disease. She has hypertension, for which she is taking ramipril, but is otherwise relatively well. As such, she is offered the option of a renal transplant.
What malignancy is she most likely to develop if she does proceed to transplantation?
1 - Basal cell carcinoma of the skin
2 - Malignant melanoma
3 - Post-transplant lymphoproliferative disorder (PTLD)
4 - Renal cell carcinoma
5 - Squamous cell carcinoma of the skin
5 - Squamous cell carcinoma of the skin
A 53-year-old man presents to his GP with a skin lesion on his lower left leg. He describes an increasing size nodule below his left knee overlying a previous burn scar he acquired 20 years ago in a house fire. He first noticed this about 3 weeks ago. He is normally fit and well and takes no other medications. He does however smoke 20 cigarettes a day. On examination, there is a non-tender 3x3cm nodule with some developing ulceration overlying a large thermal burn scar below the left knee.
What is the most likely diagnosis?
1 - Actinic keratosis
2 - Basal cell carcinoma (BCC)
3 - Diabetic ulcer
4 - Malignant melanoma
6 - Squamous cell carcinoma (SCC)
6 - Squamous cell carcinoma (SCC)
A non-healing painless ulcer associated with a chronic scar is indicative of squamous cell carcinoma (SCC)
