Squamous Cell Carcinoma

Question 1

Define squamous cell carcinoma.

Answer 1

Cutaneous squamous cell carcinoma (SCC) is the proliferation of atypical, transformed keratinocytes in the skin with malignant behaviour. It ranges from in situ tumours (also known as Bowen’s disease) to invasive tumours and metastatic disease. Precursor lesions for SCCs are called actinic (or sun-damage) keratosis.

Question 2

Explain the aetiology/risk factors of squamous cell carcinoma.

Answer 2

Sun exposure
Immunosuppression
Fair skin
Hereditary skin conditions
Older age
Male sex
Ionising radiation
Carcinogens
Actinic keratosis
Previous skin cancer

Question 3

Summarise the epidemiology of squamous cell carcinoma.

Answer 3

Non-melanoma skin cancers, also referred to more specifically as ‘keratinocyte cancers’, are the most common class of skin cancers. SCC is the second most common non-melanoma skin cancer worldwide (after basal cell carcinoma). SCCs are most frequently observed in photoexposed skin, often in those >40 years of age.

Question 4

Recognise the presenting symptoms of squamous cell carcinoma. Recognise the signs of squamous cell carcinoma on physical examination.

Answer 4

Growing tumours
Bleeding
Crusting
Evidence of sun damage to skin
Tender or itchy non-healing wound originally caused by trauma
Erythematous papules or plaques
Thin, flesh-coloured or erythematous plaques
Dome-shaped nodule
Exophytic, fungating, verrucous nodules or plaques

Question 5

Identify appropriate investigations for squamous cell carcinoma and interpret the results.

Answer 5

Incisional skin biopsy