Squamous Cell Carcinoma - Epidemiology, Pathophysiology, Work Up and Management


Date
Feb 28, 2020 10:45 AM — 11:45 AM
Event
Columbia University Medical Center Dermatology Resident Lecture
Location
Columbia University Medical Center
630 West 168th STreet, New York, NY, 10032, United States

Overview & Learning Objectives

  • This Lecture has the following learning objectives
    • Brief overview of Epidemiology of Cutaneous Squamous Cell Carcinoma (CSCC)
    • Review Pathophysiology of 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
  • We will use the following cases as guides throughout the lecture
    • 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 this lesion:
  • Tumor Size: 2.1 cm in greatest dimension (size from clinical exam)

  • A biopsy was performed:
    Pathology reveals:
    • Histology: Poorly Differentiated Squamous Cell Carcinoma
    • PNI of 120 micron nerve
    • Depth: 7 mm, invades into SQ fat

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:

  1. Would you do any further work up?
  2. How would you manage this lesion?


Case Three

A Man with an Axillary Mass

Synopsis

Case Three Clinical Questions

  1. Would you do any further work up?
  2. How would you manage this patient?
Education Dermatology Squamous Cell Carcinoma Medical Oncology
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David Michael Miller
Medical Oncologist and Dermatologist

My research interests include clinical and translational research in advanced skin cancers.

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