Cutaneous squamous cell carcinoma: High risk factors, staging and management

Hyang-Joon Park

doi:10.33161/klb.2019.52.1.3

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Park: Cutaneous squamous cell carcinoma: High risk factors, staging and management

Review Article

Korean Leprosy Bulletin 2019; 52(1): 3-8.

Published online: 23 December 2019

DOI: https://doi.org/10.33161/klb.2019.52.1.3

Cutaneous squamous cell carcinoma: High risk factors, staging and management

Hyang-Joon Park

Department of Dermatology, Gachon University, Gil Medical Center, Korea.

Corresponding author: Hyang-Joon Park. (parkhjmd@gmail.com)

Received 31 October 2019 Accepted 28 November 2019

Abstract

Cutaneous squamous cell carconoma(cSCC) is a malignant neoplasm derived from suprabasal epidermal keratinocytes, which is one of the nonmelanoma skin cancers that represent the most common malignancies in humans. Although most of cSCCs are small low-risk cancers easily treated by minor surgical procedures, some cSCCs continue to grow to be invasive SCC. They can cause not only significant morbidity and cosmetic deformity but also even metastases and death. In leprosy, chronic, recurrent ulceration and resultant scars associated with peripheral neuropathy are one of the main complications, which can give rise to cSCCs.

The primary goal of cSCC treatment is complete tumor eradication with preservation of function and good cosmesis. However, prior to treatment, the preoperative workup is performed properly and tumor risk factors influencing on the treatment and prognosis are taken into consideration.

Keywords: Cutaneous squamous cell carcinoma, Leprosy, Tumor staging, Sentinel lymph node, Treatment

Figures and Tables

Fig. 1

Cutaneous SCCs developed in chronic, recurrent foot(sole and heel) ulcers in patients with leprosy.

Fig. 2

An example of treatment algorithm in cSCC(C&E:curettage & electrosurgery, SSE:standard surgical excision, POMA:postoperative margin assessment, Mohs:Mohs

Table 1

BWH system(Alternative T staging system)

^aRisk factors include tumor diameter 2 cm or greater, poorly differentiated histologic characteristics, perineural invasion, and tumor invasion beyond the subcutaneous fat(excluding bone invasion, which automatically upgrades tumor to alternative stage T3).

Table 2

Risk stratification of primary cSCC

LR: local recurrence, NM: nodal metastasis

Table 3

Follow-up recommendation

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ORCID iDs: Hyang-Joon Park
https://orcid.org/0000-0002-2143-0080
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