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
- 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 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
- 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?
Case Three
A Man with an Axillary Mass
Synopsis
- Male in the 8th decade of life
- No immunosuppressive history
- Innumerable keratinocyte carcinomas over the last 30 years
- On nicotinamide and acitretin for chemoprophylaxis
- 1 year prior, the patient had a 3-cm poorly differentiated SCC excised from his left flank
- Left axilla contained a palpable mass, CT imaging reveals:
Case Three Clinical Questions
- Would you do any further work up?
- How would you manage this patient?
David Michael Miller
Medical Oncologist and Dermatologist
My research interests include clinical and translational research in advanced skin cancers.