Cutaneous squamous-cell carcinoma
A common skin cancer with higher metastatic risk than basal-cell carcinoma.
Cutaneous squamous-cell carcinoma (cSCC) is one of the three principal types of skin cancer, alongside basal-cell carcinoma and melanoma. It typically presents as a hard lump with a scaly surface or as an ulcer, developing over several months, and is more likely than basal-cell carcinoma to spread to distant areas.
Quick Facts
- Field
- Dermatology, plastic surgery, otorhinolaryngology
- Symptoms
- Hard lump with a scaly top or ulceration.
- Risks
- Ultraviolet radiation, actinic keratosis, tobacco smoking, lighter skin, arsenic exposure, radiotherapy, poor immune system function, HPV infection
- Diagnosis
- Tissue biopsy
- Differential
- Keratoacanthoma, actinic keratosis, melanoma, warts, basal cell cancer
- Prevention
- Decreased UV radiation exposure, quitting smoking, sunscreen
- Treatment
- Surgical removal, radiotherapy, chemotherapy, immunotherapy
- Prognosis
- Usually good
- Frequency
- 2.2 million (2015)
- Deaths
- 51,900 (2015)
Facts from the source article.
Lore & Background
Cutaneous squamous-cell carcinoma originates from squamous cells in the skin's upper layers. The most significant risk factor is extensive lifetime exposure to ultraviolet radiation from sunlight, with tanning beds also emerging as a significant source. Additional risk factors include age, poor immune system function, prior scars, chronic wounds, actinic keratosis, lighter skin, Bowen's disease, arsenic exposure, radiation therapy, tobacco smoking, previous basal-cell carcinoma, and HPV infection. Genetic predispositions such as xeroderma pigmentosum and certain forms of epidermolysis bullosa increase susceptibility.
Reader's Guide
Cutaneous squamous-cell carcinoma represents about 20% of non-melanoma skin cancers and is the second-most common skin cancer. Its significance lies in its potential for metastasis, with nodal metastasis risk of 1.9-5.2% and overall mortality of 1.5-3.4%. Prognosis is favorable without metastasis, but upon distant spread the five-year survival rate drops to approximately 34%. Preventive measures include minimizing ultraviolet exposure and using sunscreen. Surgical removal is the typical treatment, with options including simple excision, Mohs surgery, cryotherapy, and radiation therapy. For metastatic cases, chemotherapy or biologic therapy may be used. Research indicates a crucial role for FGFR2 upregulation in cSCC cell progression, with mutations in the TPL2 gene leading to overexpression of FGFR2. Following successful treatment of an initial lesion, there is a substantial risk of developing subsequent lesions.
Did You Know?
- The pre-invasive or in situ form of cSCC is termed Bowen's disease.
- Risk of metastasis is higher for cSCC arising in scars, on the lower lips, ears, or mucosa, and in immunosuppressed patients.
- Mutations in the TPL2 gene lead to overexpression of FGFR2, which activates mTORC1 and AKT pathways in cSCC cell lines.
- Heart and lung transplant recipients are at the highest risk of developing cSCC due to more intensive immunosuppressive medications.
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