Squamous Cell Carcinoma - Work Up and Management

Sep 9, 2020 9:00 PM — 10:00 PM
UMASS Memorial Dermatology Resident Lecture
UMass Memorial Dermatology
Worcester, MA, 01605, United States

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
  • 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


  • 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

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


  • 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


Case Three Clinical Questions

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

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