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Non-Melanoma Skin Cancer

Squamous Cell Carcinoma Case 1 Squamous cell carcinoma

By Magnus Balslev Avnstorp, MD, Mike Mikkelsen Lorenzen and Simon Yde, MD

Pathophysiology

Squamous cell carcinomas (SCC) are derived from the squamous cells of the skin. Compared to basal cell carcinomas they present a more aggressive growth pattern with a higher potential for metastasis if left untreated. SCCs can be defined as either low risk or high risk. High risk SCC are defined by:

  • Location in the face
  • Depth of invasion more than 2 mm
  • Tumor size more than 20 mm
  • Perineural invasion

Photo examples

Rapidly growing SCC with central ulceration and minor pus formation
Rapidly growing SCC infiltrating deeper tissues on the cheek
Ulcerating mixture of a squamous cell and a basocellular carcinoma

Treatment and surgical margins

  • Minimum 5 mm at low risk tumor
  • Minimum 10 mm at high risk tumor. (See earlier in the chapter for definition of high-risk tumor).
  • Should be radically excised to fascia, or at least excised including thick subdermal tissue.

Excision of facial tumor

Excision of facial tumors

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Procedures

Procedures