Squamous Cell Carcinoma

Topic

Review Topic

N/A

Questions

2 2

Evidence

2 2

https://upload.orthobullets.com/topic/8073/images/40b_moved.jpg

https://upload.orthobullets.com/topic/8073/images/40a_moved.jpg

https://upload.orthobullets.com/topic/8073/images/Case A - femur - xray a - Parsons_moved.gif

https://upload.orthobullets.com/topic/8073/images/Case A - femur - xray b - Parsons_moved.gif

https://upload.orthobullets.com/topic/8073/images/Case A - femur - MRI T1 - Parsons_moved.gif

https://upload.orthobullets.com/topic/8073/images/Case A - femur - MRI T2 - Parsons_moved.jpg

Introduction

Malignant soft tissue tumor found in older patients
Epidemiology
- location
  - dorsum of hand and forearm
  - most common subungual malignancy
- risk factors
  - primary risk factor is excessive exposure to ultraviolet radiation
  - actinokeratosis
  - chronic osteomyelitis
    - Marjolin's ulcer is a squamous cell carcinoma resulting from chronic draining wounds or burn scars
Prognosis
- metastasis
  - lymph node metastases and high histologic grade confer poor prognosis
  - higher metastatic potential than basal cell carcinoma

Presentation

Symptoms
- pain

Imaging

Radiographs
- recommended views
  - AP and lateral of affected area
- findings
  - lytic lesion

Treatment

Operative
- wide surgical resection +/-skin graft +/- radiation
  - indications
    - standard traditional treatment
  - adjunctive radiation
    - indications
      - lesions >2cm wide
      - 4mm deep
      - perineural invasion
      - lymph node metastases
- Mohs microsurgery
  - indications
    - becoming more popular
    - smaller lesions
    - highest cure rate
  - technique
    - lymph node biopsy may be necessary

Differential & Groups

					Treated with wide-resection alone (2)
Squamous cell (3)					•
Adamantinoma					•
Chordoma					•
Chondrosarcoma					•
Parosteal osteosarcoma					•
ASSUMPTIONS: (1) Older patient is > 40 yrs; (2) assuming no impending fracture (3) assuming no metastatic disease

Ibank

	Location	Xray	Xray	CT	B. Scan	MRI	MRI	Histo(1)
Case A	Finger

(1) - histology does not always correspond to clinical case

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Questions (2)

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(OBQ10.190) Which of the following best describes a squamous cell carcinoma that develops as a result of chronic drainage from sinus tracts or a result of burn scars? Review Topic | Tested Concept