Squamous Cell Carcinoma

Question 1

Define Squamous Cell Carcinoma?

Answer 1

Malignancy of epidermal keratinocytes of the skin

Question 2

What is Marjolin’s Ulcer?

Answer 2

It is a squamous cell carcinoma that arises in an area of chronically inflamed skin

Question 3

What is the main risk factor for Squamous Cell Carcinoma?

Answer 3

UV radiation

Sun exposure can lead to actinic keratosis (sun-induced precancerous lesion)

Question 4

What are the other risk factors for Squamous Cell Carcinoma?

Answer 4

Radiation
Carcinogens (e.g. tar derivatives, cigarette smoke)
Chronic Skin Disease (e.g. lupus)
HPV
Long-term immunosuppression
Defects in DNA repair (xeroderma pigmentosum)

Question 5

What is the epidemiology of Squamous Cell Carcinoma?

Answer 5

Second most common cutaenous malignancy (20% of all skin cancers)
Occurs mainly in Middle-Aged and Elderly People
Light-Skinned individuals are at higher risk
2-3x more common in MALES

Question 6

What are the presenting symptoms of Squamous Cell Carcinoma?

Answer 6

Skin Lesion
Ulcerated
Recurrent Bleeding
Non-Healing

Question 7

What are the signs of Squamous Cell Carcinoma on physical examination?

Answer 7

Variable appearance - may be ulcerated, hyperkeratotic, crusted or scaly, non-healing
Often on sun-exposed areas
Palpate for local lymphadenopathy

Question 8

What investigations would you do for Squamous Cell Carcinoma and why?

Answer 8

Skin Biopsy - confirm malignancy and specific type
Fine-needle aspiration or lymph node biopsy - if metastasis is suspected
Staging - Using CT, MRI or PET