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Squamous Cell Carcinomae

  1. MC site = Head and neck region (sun exposed areas)Q
  2. Most common tumor arising on the sun-exposed sites in the older people.
  3. Predisposing factors.
    1. Sunlight exposure
    2. Leukoplakia
    3. Chronic ulcers  
    4. Draining osteomyelitis (Marjolin’s ulcers)Q
    5. Old bum scar
    6. Continuous heat by a charcoal burner (Kangri ulcer)
    7. Arsenic ingestion
    8. lonising radiation
    9. Tobaccco and betal nut chewing (in oral cavity CA)
    10. Transplant recipients receiving chronic immunosuppressive therapy
    11. - Actinic ketatosis, actinic cheilitis, cutaneuos horns.
    12. - Bowen’s disease.
    13. - Xeroderma pigmentosa
    14. Lupus vulgaris.
  4. Diagnosis ultimately requires histologic confirmation (Epithelial pearl formation) Q
  5. Treatment
    1. TOC is surgical excision
  6. Verrucous carcinoma
    1. Uncommon type of squamous cell carcinoma
    2. Characterised by slow growth, fungating appearance & late deep invasion without metastasis. Q
  7. Marjolin’s ulcer
    1. Squamous cell carcinoma arises in a chronic benign ulcer or scar.
    2. The commonest ulcer to become malignant is : long standing venous ulcer.
    3. There is no lymphatic metastasis
    4. Wide surgical excision is the treatment of choice.

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