Squamous Cell Carcinoma

Question 1

Define Squamous Cell carcinoma

Answer 1

Malignancy of the epidermal keratinocytes

Local invasion and metastases

Question 2

What are the following: Actinic keratosis, SCC in Situ, Marjolin Ulcer

Answer 2

Actinic keratoses: pre-cursor lesion to SCC

SCC in Situ (Bowen’s Disease): Confined to outer layers of skin

Marjolin ulcer: Aggressive, ulcerating SCC that arises in chronic wounds, burns, scars with high metastasis rate

Question 3

Risk factors for squamous cell carcinoma

Answer 3

UV light/ sun exposure
Actinic keratosis 
Lighter skin
Family history 
HPV 
Long-term immunosuppression 
Ionising radiation
Burns 
Arsenic and tar exposure

Question 4

Epidemiology of squamous cell carcinoma

Answer 4

Second most common non-melanoma skin cancer
Often >40 yrs
Incidence higher in males
Highest in Australia
Most common skin cancer in patients with darker skin types + organ transplants

Question 5

Symptoms of squamous cell carcinoma

Answer 5

Skin lesion that is ulcerating, non-healing + recurrent bleeding
Symptoms of metastases

Actinic keratosis: A small mildly erythematous patch with keratotic hypertrophy (scales and horns)

Question 6

Signs of squamous cell carcinoma

Answer 6

Lesion is:

Hyperkeratotic, scaly/crusty, rolled edges, ulcerated, non-healing, bleeding

Question 7

Investigations for squamous cell carcinoma

Answer 7

Requires a 2 week wait referral

Skin biopsy: full thickness keratinocyte atypia

Fine needle aspiration/lymph node biopsy: ?mets

FBC/LFTs/CXR/CT/MRI/PET: staging