A burden in the hand: skin squamous cell carcinoma case report and review of the literature.
Autores
Castro, F., Santos, D., Sequeira, H., Silva, S.
Resumo Introdução
Skin cancers are the most common group of cancers diagnosed worldwide, whose incidence has been increasing. Skin squamous cell carcinoma (sSCC) is the second most common skin cancer. Diagnosis can be challenging. Workup and treatment depend on the stage, but surgical excision is almost always the first treatment option.
Resumo Métodos
A 95 year old female was brought to the hospital with a bulky 8cm hemorrhagic lesion of the wrist, without locoregional disease. It was excised and the histologic report described a free margins sSCC, with high risk features.
Resumo Resultados
sSCC comprise about 20% of the keratinocytes carcinomas. Incidence increases with age, male gender and low latitude. The major risk factor is UVR exposure. Patients may present different pigmentation and an hyperkeratotic surface, which enlarges over time becoming ulcerated, crusted, and firm upon palpation. Typical sites are sun exposed areas. Examination of the lesion and the draining basins is sufficient for low risk sSCC diagnosis, but high risk cases may need imaging to access the extent of the disease.
Resumo Discussão
The primary treatment is surgical clearance of the tumor and clear margins. Preservation of function and cosmesis are additional objectives. Advance sSCC may need regional therapeutic lymph node dissection. Histology gives the definite diagnosis and classifies the specimen in low or high risk of recurrence/metastasis. It may foresee the need of other treatments to reduce the risk of recurrence. sSCC has a cure rate of 90% at 5 years.