Patient Case Studies
Metastatic Squamous Cell Carcinoma
HISTORY 76-year-old man with a rapidly growing mass on angle of jaw. Fine needle aspiration on 12/6/16 diagnosed squamous cell carcinoma. The presumptive primary carcinoma was skin. On 12/16/16, the patient underwent a left parotidectomy and cervical lymphadenectomy. Pathology showed multiple lymph node involvement. Radiation and concurrent chemotherapy treatment began on 1/18/2017 and was completed…
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Calvarial Invasion of scalp SCC
HISTORY 72-year-old man presents with an ulcerating skin lesion on the right scalp. In March 2013, a biopsy showed pleomorphic sarcoma and the histologic differential diagnosis included atypical fibroxanthoma and malignant fibrous histiocytoma. In May 2013, Mohs excision and additional resection of the outer table of the calvarium was completed. In April 2016, a new…
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Aggressive Forehead SCC
History 78-year-old man with a recurrence of squamous cell carcinoma of forehead following surgery and radiation. Resection was performed in 4/2016 and radiation followed. Lesion recurred within 1 week of completion of radiation within radiation field. Originally presented with squamous cell carcinoma with perineural invasion and 4.5mm depth of invasion, arising from squamous cell carcinoma…
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Recurrent Extensive Basal Cell Carcinoma of Forehead
HISTORY 68-year-old man presented with a recurrent right forehead basal cell carcinoma. The carcinoma was previously treated with Mohs excision in 2002 and 2009. The recurrence appeared initially as superficial and was treated successfully with topical imiquimod. Deep recurrence became evident many months later. Morphology of the basal cell carcinoma was infiltrative with metatypical features.…
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Osteoradionecrosis of Skull
HISTORY 85-year-old man presented in 4/2016 with a 4 month history of a nonhealing scalp wound following excision of melanoma, radiation, and two failed skin grafts. Patient was treated with serial outer table of calvarium debridements – 4/2016, 7/2016, 11/2016. Patient had a consultation with UCI team for full thickness calvarial resection and microvascular reconstruction.…
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Lower Leg Radiation Ulcer
HISTORY 85-year-old man presented in March 2015 with a multi-year history of a non-healing right lower leg lesion. Shave biopsy found squamous cell carcinoma in situ with focal areas of early invasion. Superficial radiotherapy was prescribed at 50 kvp 5 days per week for 5 weeks ending in July 2015. Minor skin erosion present 3…
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Deeply Invasive Cheek Squamous Cell Carcinoma
HISTORY 86-year-old man presented in June 2017 with a 2 month history of squamous cell carcinoma of the left cheek. The lesion was partially treated with Mohs surgery on 6/12/2017. Due to the size of the defect and depth of extension into the ear and the parotid gland, Mohs surgery was stopped after 3 levels.…
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Sclerosing Adnexal Carcinoma of Nose
HISTORY 74-year-old man presented in June 2017 with 2-month history of scabbing of the left nose. A biopsy performed 5/11/17 revealed sclerosing carcinoma of left nose. The lesion is an 8mm plaque at the base of the left nasal ala. Mohs and reconstruction are being planned. DISCUSSION The histology of the sclerosing carcinoma is presented…
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Foreign Body Granuloma of Forehead
HISTORY 43-year-old woman presented in June 2013 with 6-month history of 1 cm forehead nodule that appeared during pregnancy. The soft lesion fluctuated in size according to the patient. Excisional biopsy performed on 6/1/17 revealed chronic granulomatous inflammation around refractile foreign material. The lesion appeared to be recurring 2 weeks post-operatively. DISCUSSION Foreign body granuloma…
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Topical 5-fluorouracil and Imiquimod Efficacy in Basal and Squamous Cell Carcinomas
HISTORY 65-year-old woman presented in January 2017 with a nasal dorsum squamous cell carcinoma in situ. The nasal lesion was treated with 6 weeks of topical 5-fluorouracil with a robust inflammatory response. A separate chin basal cell carcinoma was simultaneously treated with 6 weeks of imiquimod prescribed in February, while still undergoing 5-fluorouracil on the…
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