summary Squamous Cell Carcinoma is a malignant soft tissue tumor most commonly found in elderly patients. Diagnosis is made with a biopsy. Treatment is wide surgical resection with or without radiation and skin grafting. Epidemiology Anatomic location dorsum of hand and forearm most common subungual malignancy Risk factors primary risk factor is excessive exposure to ultraviolet radiation actinokeratosis Solid organ transplant chronic osteomyelitis Marjolin's ulcer is a squamous cell carcinoma resulting from chronic draining wounds or burn scars Presentation Symptoms pain Imaging Radiographs recommended views AP and lateral of affected area findings lytic lesion Differential Differential of Squamous Cell Carcinoma Treated with wide-resection alone Squamous cell o Adamantinoma o Chordoma o Chondrosarcoma o Parosteal osteosarcoma o Treatment Operative wide surgical resection +/-skin graft +/- radiation indications login to view 1 more bullet adjunctive radiation login to view 5 more bullets Mohs microsurgery indications login to view 3 more bullets technique login to view 1 more bullet Prognosis Metastasis lymph node metastases and high histologic grade confer poor prognosis higher metastatic potential than basal cell carcinoma