Squamous cell carcinoma (SCC), is the second most common form of skin cancer. This cancer is an uncontrolled growth of abnormal cells arising from the squamous cells in the epidermis, the skin's outermost layer. It is sometimes called cutaneous squamous cell carcinoma (CSCC) to differentiate it from very different kinds of SCCs elsewhere in the body (e.g. lung). Cutaneous is the scientific word for "related to or affecting the skin." Show
What do SCC's look like?SCC's can appear in different forms:
SCCs may occur on all areas of the body, including the mucous membranes and genitals, but are most common in areas frequently exposed to the sun, such as the rim of the ear, lower lip, face, balding scalp, neck, hands, arms and legs. The skin in these areas often reveals telltale signs of sun damage, including wrinkles, pigment changes, freckles, "age spots," loss of elasticity and broken blood vessels. Are SCC's dangerous?If caught early, most squamous cell carcinomas are curable and cause minimal damage. However, the larger and deeper a tumour grows, the more dangerous and potentially disfiguring it may become, and the more extensive the treatment must be. SCC's can be classified according to their pathological grades. The most common form is SCC-in-situ which is also known as Bowen's Disease, or Intraepidermal Carcinoma (IEC). These are SCC's on the very surface of the skin, which has not yet developed the potential to invade or spread. Invasive SCC's are divided into three grades: well-differentiated, moderately-differentiated and poorly-differentiated in the order of least aggressive to the most aggressive. Poorly-differentiated SCC's are known to grow rapidly, metastasis and can be highly recurrently. If left untreated, SCCs may spread (metastasize) to local lymph nodes, distant tissues and organs and can become life-threatening. Treatment of metastatic SCC often include extensive surgery, radiotherapy and chemotherapy. What are SCC's caused by?Cumulative, long-term exposure to ultraviolet (UV) radiation from the sun over your lifetime causes most SCCs. Daily year-round sun exposure, intense exposure in the summer months or on sunny vacations and the UV produced by indoor tanning devices all add to the damage that can lead to SCC. Experts believe that indoor tanning is contributing to an increase in cases among young women, who tend to use tanning beds more than others do. How are SCC's diagnosed?SCC's are diagnosed with a biopsy (a sample of tissue from the lesion), which is examined under a microscope by a pathologist. Often, the subtype/grade of the SCC can be determined with the biopsy sample. What are the treatments available for SCC's?Fortunately, there are several effective ways to eradicate squamous cell carcinoma. Treatment recommendation is based on the tumor's type, size, location and depth of penetration, as well as the patient's age and general health. IEC's can generally be treated with topical treatment or minor surgery. Invasive SCC's often require surgery, with or without adjuvant radiotherapy. Talk to your doctor about your best options of treatment. To find out more about Skin Cancer and Surgery, visit our page on Skin Cancer Surgery or read our blogs on skin cancers.
Review . 2015 Sep;51(14):1989-2007. doi: 10.1016/j.ejca.2015.06.110. Epub 2015 Jul 25. Claus Garbe 2 , Celeste Lebbe 3 , Josep Malvehy 4 , Veronique del Marmol 5 , Hubert Pehamberger 6 , Ketty Peris 7 , Jürgen C Becker 8 , Iris Zalaudek 9 , Philippe Saiag 10 , Mark R Middleton 11 , Lars Bastholt 12 , Alessandro Testori 13 , Jean-Jacques Grob 14 , European Dermatology Forum (EDF); European Association of Dermato-Oncology (EADO); European Organization for Research and Treatment of Cancer (EORTC) Affiliations
Review Diagnosis and treatment of invasive squamous cell carcinoma of the skin: European consensus-based interdisciplinary guidelineAlexander Stratigos et al. Eur J Cancer. 2015 Sep. AbstractCutaneous squamous cell carcinoma (cSCC) is one of the most common cancers in Caucasian populations, accounting for 20% of all cutaneous malignancies. A unique collaboration of multi-disciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organization of Research and Treatment of Cancer (EORTC) was formed to make recommendations on cSCC diagnosis and management, based on a critical review of the literature, existing guidelines and the expert's experience. The diagnosis of cSCC is primarily based on clinical features. A biopsy or excision and histologic confirmation should be performed in all clinically suspicious lesions in order to facilitate the prognostic classification and correct management of cSCC. The first line treatment of cutaneous SCC is complete surgical excision with histopathological control of excision margins. The EDF-EADO-EORTC consensus group recommends a standardised minimal margin of 5 mm even for low-risk tumours. For tumours, with histological thickness of >6 mm or in tumours with high risk pathological features, e.g. high histological grade, subcutaneous invasion, perineural invasion, recurrent tumours and/or tumours at high risk locations an extended margin of 10 mm is recommended. As lymph node involvement by cSCC increases the risk of recurrence and mortality, a lymph node ultrasound is highly recommended, particularly in tumours with high-risk characteristics. In the case of clinical suspicion or positive findings upon imaging, a histologic confirmation should be sought either by fine needle aspiration or by open lymph node biopsy. In large infiltrating tumours with signs of involvement of underlying structures, additional imaging tests, such as CT or MRI imaging may be required to accurately assess the extent of the tumour and the presence of metastatic spread. Current staging systems for cSCC are not optimal, as they have been developed for head and neck tumours and lack extensive validation or adequate prognostic discrimination in certain stages with heterogeneous outcome measures. Sentinel lymph node biopsy has been used in patients with cSCC, but there is no conclusive evidence of its prognostic or therapeutic value. In the case of lymph node involvement by cSCC, the preferred treatment is a regional lymph node dissection. Radiation therapy represents a fair alternative to surgery in the non-surgical treatment of small cSCCs in low risk areas. It generally should be discussed either as a primary treatment for inoperable cSCC or in the adjuvant setting. Stage IV cSCC can be responsive to various chemotherapeutic agents; however, there is no standard regimen. EGFR inhibitors such as cetuximab or erlotinib, should be discussed as second line treatments after mono- or polychemotherapy failure and disease progression or within the framework of clinical trials. There is no standardised follow-up schedule for patients with cSCC. A close follow-up plan is recommended based on risk assessment of locoregional recurrences, metastatic spread or development of new lesions. Keywords: Cutaneous squamous cell carcinoma; Diagnosis; Follow up; Management; Pathology; Prognosis; Radiation therapy; Surgical excision; Systemic treatment. Copyright © 2015 Elsevier Ltd. All rights reserved. Similar articles
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What does invasive squamous cell carcinoma wellIn cancer, well-differentiated cancer cells look more like normal cells under a microscope and tend to grow and spread more slowly than poorly differentiated or undifferentiated cancer cells.
What is the treatment of wellChemotherapy. Chemotherapy uses powerful drugs to kill cancer cells. If squamous cell carcinoma spreads to the lymph nodes or other parts of the body, chemotherapy can be used alone or in combination with other treatments, such as targeted drug therapy and radiation therapy.
How serious is invasive squamous cell carcinoma?Squamous cell carcinoma of the skin is usually not life-threatening, though it can be aggressive. Untreated, squamous cell carcinoma of the skin can grow large or spread to other parts of your body, causing serious complications.
What stage is wellLow grade or grade I tumors are well-differentiated. This means that the tumor cells are organized and look more like normal tissue. High grade or grade III tumor cells are poorly differentiated.
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Invasive well differentiated squamous cell carcinoma treatment
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