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Cutaneous Squamous Cell Carcinoma

  1. Introduction
    Being the second most common malignant tumour of the skin, scc possesses a higher potential for metastasis than bcc (3%-30% in scc and 0.3%-3% in bcc).
  2. Factors Of Predisposing For Scc.
    1. Actinic damage is the most important factor but sccs may also develop in certain
    2. Geno-Dermatosis,
    3. Immunologically Compromised
    4. Chronic Inflammation,
    5. UV Radiation
    6. Ionizing Radiation,
    7. Arsenic Poisoning.
  3. Risk Factors
    The Following Factors are Associated with Increased Aggressiveness:
    1. Size > 1 Cm
    2. Rapid Growth
    3. Ulceration
    4. Depth: Invasion Into Subcutis Or Below
    5. Immunocompromised
    6. Develop From Chronic Inflammation Or Scar
    7. Recurrence
    8. Site: Mucous Membrane, Ear, Temple, Scalp, Eyelid
    9. Histology: Undifferentiated, Subcutaneous Or Below, Perineural Invasion, Lymphatic Invasion.
  4. Squamous Cell Carcinoma:
    1. The natural history of scc depends on both tumor and host characteristics.
    2. Tumors arising on actinic ally damaged skin have a lower metastatic potential than those on protected surfaces.
    3. The metastatic frequency of cutaneous scc, occurs most frequently in regional draining lymph nodes.
    4. Tumors oc­curring on the lower lip and ear have metastatic potentials respectively.
    5. The metastatic potential of scc arising in scars, chronic ulcerations, and genital or mucosal surfaces is higher.
    6. The overall metastatic rate for recurrent tumors may approach 30%.
    7. Large, poorly differentiated, deep tumors, with perineural or lymphatic invasion, often behave aggressively. Multiple tumors with rapid growth and aggressive behavior be a therapeutic challenge in im­munosuppressed patients.
  5. Treatment
    Squamous cell carcinoma the therapy of cutaneous scc should be based on an analysis of risk factors influencing the biologic behavior of the tumor.
    1. These include the size, location, and degree of histologic differentiation of the tumor as well as the age and physical condition of the patient. Surgical excision, mms, and radiation therapy are stan­dard methods of treatment.
    2. Cryosurgery and ed&c have been used successfully for premalignant lesions and small primary tumors.
    3. Me­tastases are treated with lymph node dissection, irradiation, or both. 13-cis-retinoic acid (1 mg orally every day) plus interferon α may produce a partial response in most patients. Systemic chemotherapy combinations that include cisplatin may also be palliative in some patients.

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