Squamous Cell Carcinoma Flashcards
What is squamous cell carcinoma related to?
Sun exposure
May arise in pre-existing solar keratoses
What are risk factors of squamous cell carcinoma?
Excessive exposure to sunlight Actinic keratoses and Bowen's disease Immunosuppression e.g. organ transplant and HIV Smoking Long-standing leg ulcers Genetic conditions
What is the treatment of squamous cell carcinoma?
Surgical excision with 4mm margins if <20mm in diameter or 6mm if >20mm in diameter.
May metastasize if left
Wide local excision is the treatment of choice where a diagnostic excision biopsy has demostrated SCC, repeat surgery to gain adequate margins may be required.
What pattern of UV light exposure is associated with squamous cell carcinoma?
SSCs are associated with chronic long-term exposure
What is the pre-malignant lesion of squamous cell carcinoma?
Actinic keratosis
In a person with 7 actinic keratosis there is a 10% risk of SSC at 10 years
How may SCC present?
Bowen’s disease (SCC in situ)
Erythematous scalying patch or elevated plaque arising on sun-exposed skin in an elderly patient.
Invasive SCC
Erythmatous keratotic papule or nodule on a background of sun exposure. ULCERATION may occur and both exophytic and endophytic areas may be seen.
Regional lymphadenopathy may be present.
What is found pathologically in SCC?
Full thickness atypia of dermal keratinocytes oveer a broad zone.
Nuclear pleomorphism, apoptosis and abnoral mitoses are seen.
In what proportion of patients with SCC may metastases occur?
2-5%
What are factors indicating a good prognosis in SSC?
Well differentiated tumours
<20mm diameter
<2mm deep
No associated diseases
What are factors indicating a poor prognosis in SSC?
Poorly differentiated tumours
>20mm in diameter
>4mm deep
Immunosupression for whatever reason
