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 Riisk 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 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 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 Prognosis Metastasis lymph node metastases and high histologic grade confer poor prognosis higher metastatic potential than basal cell carcinoma
QUESTIONS 1 of 5 1 2 3 4 5 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (SBQ17SE.82) A 56-year-old construction worker who lives in El Paso presents with a large, indurated, scaly, erythematous lesion of the left hand. A clinical photo is depicting in Figure A. He reports this lesion appeared about 2 years ago and has progressively worsened over the last several months. A punch biopsy is performed with Figure B demonstrating the histologic findings. What is the most appropriate treatment option for this patient? QID: 212007 FIGURES: A B Type & Select Correct Answer 1 Transradial amputation 2% (24/1411) 2 Cultures at 30-32° C with culture sensitive anti-mycobacterial agents 19% (266/1411) 3 Rheumatologic consult for disease modifying antirhuematic drugs 5% (64/1411) 4 Local fractionated radiation 2% (32/1411) 5 Wide local resection 72% (1013/1411) L 3 Question Complexity A Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept Review Full Topic (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? QID: 3288 Type & Select Correct Answer 1 Cushing's ulcer 3% (71/2361) 2 Mooren's ulcer 1% (30/2361) 3 Chancroid ulcer 2% (52/2361) 4 Marjolin's ulcer 88% (2074/2361) 5 Curling's ulcer 5% (124/2361) L 1 Question Complexity C Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK