SQUAMOUS CELL CARCINOMA

Question 1

SQUAMOUS CELL CARCINOMA

Lesion

Answer 1

• hyperkeratotic indurated, pink/red/skin-coloured papule/plaque/nodule with surface scale/crust ±
ulceration
• more rapid enlargement than BCC
• exophytic (grows outward), may present as a cutaneous horn

Question 2

SQUAMOUS CELL CARCINOMA Sites

Answer 2

face, ears, scalp, forearms, dorsum of hands

Question 3

SQUAMOUS CELL CARCINOMA

Pathophysiology

Answer 3

malignant neoplasm of keratinocytes (primarily vertical growth)

Question 4

SQUAMOUS CELL CARCINOMA

predisposing factors :

Answer 4

cumulative UV radiation, PUVA, ionizing radiation therapy/exposure,
chemical carcinogens (such as arsenic, tar, and nitrogen mustards), HPV 16, 18, immunosuppression

Question 5

SQUAMOUS CELL CARCINOMA scars?

Answer 5

• may occur in previous scar (SCC more commonly than BCC)

Question 6

SQUAMOUS CELL CARCINOMA

Prevalence.

Answer 6

second most common type of cutaneous neoplasm

Question 7

SQUAMOUS CELL CARCINOMA Population affected

Answer 7

elderly, M>F, skin phototypes I and II, chronic sun exposure
in organ transplant recipients, SCC is most common cutaneous malignancy, with increased mortality as
compared to non-immunocompromised population

Question 8

SQUAMOUS CELL CARCINOMA

Diff Dx

Answer 8

benign: nummular eczema, psoriasis, irritated seborrheic keratosis
• pre-malignant: Actinic Keratosis, Bowenoid papulosis
• malignant: keratoacanthoma, Bowen’s disease, BCC, amelanotic melanoma

Question 9

SQUAMOUS CELL CARCINOMA

Management

Answer 9

• surgical excision with primary closure, skin flaps or grafting
• Mohs surgery
• lifelong follow-up (more aggressive treatment than BCC)
• radiation therapy

Question 10

SQUAMOUS CELL CARCINOMA

good prognostic factors

Answer 10

early treatment, negative margins, and small size of lesion

Question 11

SQUAMOUS CELL CARCINOMA

Metastasize. SCC from AK

Answer 11

SCCs that arise from AK metastasize less frequently (~1%) than other SCCs arising de novo in old
burns (2-5% of cases)
•

Question 12

SQUAMOUS CELL CARCINOMA prognosis

Answer 12

overall control is 75% over 5 yr, rate of metastasis from primary SCC is 2-5%

Question 13

SQUAMOUS CELL CARCINOMA when is the prognosis worst?

Answer 13

metastasis rates are higher if diameter >2 cm, depth >4 mm, recurrent, involvement of bone/muscle/
nerve, location on scalp/ears/nose/lips, immunosuppressed, caused by arsenic ingestion, or tumour
arose from scar/chronic ulcer/burn/genital tract/sinus tract