Squamous Cell Carcinoma

Question 1

SCC

Answer 1

2nd most common type, can mets, common in light skin, found on sun exposed areas

Question 2

Risk factors SCC

Answer 2

UV exposure, tanning bed, therapeutic UV exposure for psoriasis, radiation therapy, arsenic exposure, smoking, immunosuppression, fitzpatrick 1&2

Question 3

Pathogenesis of SCC

Answer 3

Keratinocytes become transformed d/t the mutation of the p53 gene which becomes resistent to cell death and replicates rapidly

Question 4

Where can it develop

Answer 4

Skin, mouth, esophagus, vagina, anus

Question 5

Clinical features SCCIS

Answer 5

Erythematous scaly patch

Question 6

Erythroplasia of Queyrat location

Answer 6

penis

Question 7

Bowenoid papulosis

Answer 7

genital condyloma a/w HPV 16 & 18

Question 8

Cutenous horn

Answer 8

horn like projection from skin often on the face with rapid growth

Question 9

Location

Answer 9

bald scalp, face, neck, dorsal arms and hands, pretibial

Question 10

Clinical Variants of SCC

Answer 10

1) Pigmented 2) KA 3) Verrucuous with subtypes a) Epithelioma cuniculatium on the plantar foot b) Giant condyloma acuminatum of genitalia (buscke-lowenstein tumor) and c) oral papillomatosus (oral HPV)

Question 11

Pathology well differentiated v poorly differentiated

Answer 11

well: atypical keratinocytes with nucleus atypia. poorly: no keratinocytes, nucleus atypia, spindle cell morphology

Question 12

mets risks

Answer 12

tumor thickness > 2mm, diameter > 2cm. locations of ears, lips, penis, vulva, occurence in a prior radiated area, poorly differentiated type, those on immunosuppressives

Question 13

mets starts with

Answer 13

lymphatics with the organ involvement of lungs or bone

Question 14

tx SCCIS

Answer 14

Excision, ED&C, 5FU BID X 4-8 weeks or Imiquimod once daily x 4 weeks

Question 15

tx SCC invasive

Answer 15

radiation when surgery cannot be performed, wide excision 4mm-6mm margins, MOHS is gold standard, refer to onc for mets