Overview
What is cutaneous squamous cell carcinoma (cSCC)?
What are the signs and symptoms of cutaneous squamous cell carcinoma (cSCC)?
What is included in the diagnostic workup of suspected cutaneous squamous cell carcinoma (cSCC)?
What are treatment options for cutaneous squamous cell carcinoma (cSCC)?
How common is cutaneous squamous cell carcinoma (cSCC)?
What is the prognosis of cutaneous squamous cell carcinoma (cSCC)?
How is cutaneous squamous cell carcinoma (cSCC) diagnosed?
How is cutaneous squamous cell carcinoma (cSCC) prevented?
What is the role of chemotherapy in the treatment of cutaneous squamous cell carcinoma (cSCC)?
What is the hallmark of cutaneous squamous cell carcinoma (cSCC)?
What is the role of genetics in the pathogenesis of cutaneous squamous cell carcinoma (cSCC)?
What is a precursor to invasive cutaneous squamous cell carcinoma (cSCC)?
What are the histologic grades for conventional cutaneous squamous cell carcinoma (cSCC)?
What are the risk factors for cutaneous squamous cell carcinoma (cSCC)?
What is the role of immunosuppression in the etiology of cutaneous squamous cell carcinoma (cSCC)?
What is the role of genetics in the etiology of cutaneous squamous cell carcinoma (cSCC)?
Which dermatoses increase the risk for cutaneous squamous cell carcinoma (cSCC)?
What is the role of hypothyroidism in the etiology of cutaneous squamous cell carcinoma (cSCC)?
What is the role of DNA repair failure in the etiology of cutaneous squamous cell carcinoma (cSCC)?
How does immunosuppression increase the risk for cutaneous squamous cell carcinoma (cSCC)?
What is the primary risk factor for squamous cell carcinoma (SCC) in organ transplant patients?
How is squamous cell carcinoma (SCC) characterized in organ transplant recipients?
What is the prevalence of cutaneous squamous cell carcinoma (cSCC)?
What is the global incidence of cutaneous squamous cell carcinoma (cSCC)?
Which geographic locations have the highest incidence of cutaneous squamous cell carcinoma (cSCC)?
What are the racial predilections of squamous cell carcinoma (SCC)?
How does the prevalence of squamous cell carcinoma (SCC) vary by sex?
What is the prognosis of primary cutaneous squamous cell carcinoma (cSCC)?
How is cutaneous squamous cell carcinoma (cSCC) staged?
What are the survival rates for advanced-stage cutaneous squamous cell carcinoma (cSCC)?
How does the depth of lesions affect the prognosis of primary squamous cell carcinoma (SCC)?
How does cellular differentiation affect the prognosis of squamous cell carcinoma (SCC)?
What are the risk factors for tumor recurrence in squamous cell carcinoma (SCC)?
How does perineural invasion affect the prognosis of squamous cell carcinoma (SCC)?
How does lymph node ratio affect the prognosis of squamous cell carcinoma (SCC)?
What is included in patient education about cutaneous squamous cell carcinoma (cSCC)?
Presentation
What is the focus of history in the evaluation of cutaneous squamous cell carcinoma (cSCC)?
How are lesions described in cutaneous squamous cell carcinoma (cSCC)?
What is the appearance of precancerous lesions in cutaneous squamous cell carcinoma (cSCC)?
What is the classic presentation of a cutaneous squamous cell carcinoma (cSCC)?
What are the characteristics of cutaneous squamous cell carcinoma (cSCC) tumors?
Which physical findings suggest conjunctiva involvement in squamous cell carcinoma (SCC)?
Which patients are at higher risk for conjunctival squamous cell carcinoma (SCC)?
DDX
How is cutaneous squamous cell carcinoma (cSCC) diagnosed?
What are the differential diagnoses for Cutaneous Squamous Cell Carcinoma?
Workup
What is the role of biopsy in the workup of cutaneous squamous cell carcinoma (cSCC)?
How is advance stage cutaneous squamous cell carcinoma (cSCC) evaluated?
When is biopsy indicated in the workup of cutaneous squamous cell carcinoma (cSCC)?
How is biopsy performed in the evaluation of cutaneous squamous cell carcinoma (cSCC)?
What is the staging system used for cutaneous squamous cell carcinoma (cSCC)?
How is cutaneous squamous cell carcinoma (cSCC) staged?
What is the N1S3 staging system for metastatic cutaneous squamous cell carcinoma (cSCC)?
Treatment
What are the treatment options for cutaneous squamous cell carcinoma (cSCC)?
What are potential complications of surgical excision for cutaneous squamous cell carcinoma (cSCC)?
What is the role of radiation therapy for the treatment of cutaneous squamous cell carcinoma (cSCC)?
What are the treatment options for conjunctival squamous cell carcinoma (SCC)?
What is involved in surgery for conjunctival squamous cell carcinoma (SCC)?
How is cryotherapy performed for the treatment of conjunctival squamous cell carcinoma (SCC)?
How is reconstruction performed for the treatment of squamous cell carcinoma (SCC)?
How is conjunctival intraepithelial neoplasia treated?
How is cutaneous squamous cell carcinoma (cSCC) prevented?
What is the role of sunscreen in the prevention of cutaneous squamous cell carcinoma (cSCC)?
What is the role of clothing in the prevention of cutaneous squamous cell carcinoma (cSCC)?
What are the guidelines for skin screening to prevent cutaneous squamous cell carcinoma (cSCC)?
What are the treatment options of squamous cell carcinoma in situ (SCCIS)?
What is included in long-term monitoring of cutaneous squamous cell carcinoma (cSCC)?
Guidelines
Medications
What is included in nonsurgical management of cutaneous squamous cell carcinoma (cSCC)?
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Large, sun-induced squamous cell carcinoma (SCC) on the forehead/temple. Image courtesy of Glenn Goldman, MD.
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Preauricular and helical scars (black arrows) from prior excisions are noted in a patient who presented with cervical metastases (white arrow) from an occult cutaneous squamous cell carcinoma.
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Contrast-enhanced, axial computed tomography (CT) scan of a patient with soft tissue invasion of the right parotid gland (arrow) by an ulcerative cutaneous squamous cell carcinoma.
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Large, neglected cutaneous squamous cell carcinoma of the right ear that requires wide local excision via auriculectomy and reconstruction. The risk of lymph node metastasis with this deeply ulcerative tumor is high enough to warrant elective neck dissection.
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Squamous cell carcinoma in situ (Bowen disease). Courtesy of Hon Pak, MD.
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Extensive conjunctival squamous cell carcinoma of the left eye. The patient had limbal and corneal involvement temporally, as well as scleral invasion with intraocular spread. A malignant cellular reaction in the anterior chamber was present. The patient was treated with a lid-sparing exenteration.
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A 35-year-old man with human immunodeficiency virus (HIV) infection presented with a 2-year history of a slowly enlarging, left lower eyelid lesion; incisional biopsy revealed squamous cell carcinoma.
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Axial magnetic resonance image (MRI) of a large squamous cell carcinoma of the left lower eyelid with invasion of the anterior orbit.
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A large, ulcerated, invasive squamous cell carcinoma of the left lower eyelid. This patient also had perineural invasion of the infraorbital nerve extending into the cranial base.
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Progressively severe atypia. The epithelium to the left is close to normal, but the epithelium to the right shows full-thickness atypia (ie, carcinoma in situ). This image illustrates carcinogenesis, the process whereby cells exposed to a carcinogen become cancerous over time.
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Squamous cell carcinoma. The lesion closely approximates the specimen in the previous image. Field cancerization is illustrated; that is, if >1 cell is exposed to a carcinogen, >1 cell becomes cancerous. Note the marked inflammatory-cell response. Should limited biopsy reveal only severe atypia with a severe inflammatory response, the lesion should be investigated further, because a cancer is likely nearby.