Squamous cell carcinoma treatment can almost always be performed on an outpatient basis. Submit an online appointment request or call if you observe changes in the appearance of your skin, such as finding a new growth, a change to a previous growth, or a recurring sore. Wide Local Excision. Sentinel Lymph Node Biopsy. Completion Node Dissection. Immunotherapy for Melanoma.
Radiation Therapy for Melanoma. Chemotherapy for Metastatic Melanoma. Target Therapy. Melanoma and Skin Cancer Clinical Trials. Patient Support Resources.
Squamous Cell Skin Carcinoma. Conditions Squamous Cell Carcinoma of the Skin. What is Squamous Cell Cancer? There are 5 Stages of Squamous Cell Skin Cancer Stage 0 is Carcinoma in situ This stage is not considered invasive cancer as the abnormal cells are only in the upper layer of the skin, the epidermis.
Stage 1 and 2 This stage is determined by how big the cancer is and if there is high-risk features of the tumor. Stage 3 This stage has spread to areas below the skin, such as into lymph nodes or other local structures like muscle, bone or cartilage Stage 4 This stage has spread to distant sites. If your doctor suggests radiation treatment, talk about what side effects might happen. The most common side effects of radiation are:. Most side effects get better after treatment ends.
Some might last longer. Talk to your cancer care team about what you can expect. There are ways to treat skin cancer without cutting into the skin. Some of these use freezing, chemo or other drugs put right on the skin, light therapy PDT , or lasers to kill cancer cells. Make sure you know what the treatment will be like and how your skin will feel and look after it. Immunotherapy is treatment that boosts your own immune system to attack the cancer cells.
It can be used to treat some advanced squamous cell skin cancers. It is given as a shot into a vein. Immunotherapy can cause many different side effects. They are usually mild, but some can be serious. Most of these problems go away after treatment ends. There are ways to treat most of the side effects from immunotherapy.
If you have side effects, talk to your cancer care team so they can help. Targeted therapy drugs may be used for certain types of skin cancer. These drugs find and attack cancer cells while doing little harm to normal cells. Each drug works in a different way, but they change the way cancer cells grow, divide, or repair themselves. Targeted drugs can cause different side effects. There are ways to treat most of the side effects from targeted drugs. Chemo is the short word for chemotherapy — the use of drugs to fight cancer.
This treatment uses drugs that are put into a vein or taken as a pill. These drugs travel through the bloodstream to all parts of the body. Chemo can make you feel very tired, sick to your stomach, and cause your hair to fall out.
But these problems go away after treatment ends. There are ways to treat most chemo side effects. If you have side effects, be sure to talk to your cancer care team so they can help.
Clinical trials are research studies that test new drugs or other treatments in people. They compare standard treatments with others that may be better. Clinical trials are one way to get the newest cancer treatment. They are the best way for doctors to find better ways to treat cancer.
Ultimately, his left helical rim keloid was removed by shave technique, which resulted in a cookie-bite type deformity of his left ear Figure 1A , white arrow. Panel A shows the left-sided temporal nodule black arrow and a cookie-bite type deformity of the left ear white arrow. Panel B shows a close-up photograph of the left temporal nodule black arrow. In our clinic, he underwent a diagnostic excision of the left temporal lesion. The excision failed to reveal a circumscribed cyst.
Rather, an ill-defined and friable subcutaneous mass had been excised. Panel A shows a dense collection of keratinocytes with host-mediated inflammation red arrows that notably spare the epidermis.
Higher magnification shown in panel B reveals cells with nuclear atypia white arrows and mitoses black arrow. Further immunostaining with p63 confirmed primary cutaneous origin of these malignant keratinocytes panel B.
These findings confirmed a diagnosis of primary cutaneous metastatic SCC. No primary SCC was identified. Also, additional metastatic SCC was not observed. His left temple metastasis was fully extirpated through Mohs micrographic surgery MMS. At 11 months follow-up, he remains cancer-free and shows no signs of recurrence Figure 4. Follow up examination at 11 months post-Mohs surgery shows a well-healed scar black arrow and no signs of recurrence.
Since our patient did not have a prior history of skin cancer and since no other cutaneous or systemic SCC was discovered, we speculate that his left helical rim "pre-cancer" may have indeed been an SCC that subsequently metastasized to his temple. When metastasis does occur, the vast majority of metastases are found in the parotid or cervical lymph nodes. The primary site with the highest risk of metastasis is the ear [ 7 , 8 ].
Although metastasis in cSCC is rare, certain features can estimate the likelihood of metastasis. High-risk features include diameter greater than 2 cm, depth of invasion greater than 4 mm or through subcutaneous fat, perineural involvement, poor differentiation on histology, location on high-risk areas such as the lip or ear, tumor recurrence, and an immunocompromised state [ 9 - 11 ].
Clark's level describes the level of anatomical invasion of cancer in the skin. Level I is confined to the epidermis. Level II indicates invasion into the papillary dermis. Level III indicates invasion to the junction of the papillary and reticular dermis. Level IV indicates invasion into the reticular dermis. Level V indicates invasion into the subcutaneous tissue. Management of cSCC depends on the presence of high-risk features.
In low-risk cSCC, standard surgical excision is generally acceptable. MMS allows for visualization of all margins of the specimen in real time, thus ensuring that the tumor is clear prior to closure. This provides a strong therapeutic advantage in high-risk cSCC, as these tumors may be deeper or more infiltrative.
Treatment for metastatic cSCC is similar to primary lesions and includes surgery, radiotherapy, and chemotherapy. The presence of distant metastases is an indication for chemotherapy, whereas regional metastases are treated with surgery or radiation or a combination of the two. Veness et al. Furthermore, targeted therapies, including EGFR inhibitors, PD-1 inhibitors cemiplimab , and p53 inhibitors, are and continue to emerge as novel and effective therapies for cSCC [ 9 , 12 ].
Although relatively rare, metastatic cSCC is potentially deadly.
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