Squamous Cell Carcinoma - Work Up and Management
Pearls for the Work Up & Management of CSCC
Overview & Learning Objectives
- This Lecture has the following learning objectives
- Brief overview of Epidemiology of
Cutaneous Squamous Cell Carcinoma(CSCC) - Review Staging
- Review Prognosis of Advanced CSCC (AdVCSCC)
- Review Work Up of CSCC
- Discuss recently approved therapeutic strategies in CSCC, including the use of
Immune Checkpoint Inhibitors(ICIs) as primary treatment, as well as emerging strategies in the neo-adjuvant and adjuvant setting
- Brief overview of Epidemiology of
- We will use the following cases as guides throughout the lecture
- These are fictional cases, any apparent relationship to actual patients is purely coincidental.
- These are fictional cases, any apparent relationship to actual patients is purely coincidental.
Clinical Cases
Case One
A 37-year-old Male with a Lesion on the NLF
Synopsis
- A 37-year-old Male with a history of poorly controlled T1DM, s/p allogeneic kidney transplant (on tacrolimus 3.5 mg BID) 7 years ago presents with a 2.1 cm (greatest dimension from clinical exam) ulcerated plaque on the right naso-labial fold, extending on to the cheek.
- A biopsy was performed:
Pathology reveals:- Histology:
Poorly Differentiated Squamous Cell Carcinoma
- PNI of 120 micron nerve
- Depth: 7 mm, invades into SQ fat
- Histology:
Case One Clinical Questions:
- What is this patient’s T stage?
- What staging system(s) do you use to stage primary lesions in cutaneous SCC?
- What would be your next steps in work up?
Case Two
A Woman with a Facial Mass
Synopsis
- A woman in her 7th decade of life presents with a 10-cm multifocal mass on her right cheek/temple
- MRI demonstrates PNI tracking along facial nerve to the stylomastoid foramen
- A punch biopsy confirms of
Poorly Differentiated Squamous Cell Carcinoma
Case Two-Based Questions:
- Would you do any further work up?
- How would you manage this lesion?
