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Squamous Cell Carcinoma

Recurrent Bowen’s Disease of Temple

recurrent-bowens-disease-squamous-cell-carcinoma-topical-chemotherapy

HISTORY 63-year-old man presents with 9-month history of Bowen’s disease of right anterior and posterior sideburn biopsied on 08-20-18. History of previous Mohs excision of Bowen’s disease of the same area in February 2016. Patient has a history of multiple basal cell carcinomas, squamous cell carcinomas, and melanoma. DISCUSSION Management of this lesion is best…

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Cystic Squamous Cell Carcinoma of Forearm Skin

cystic-squamous-cell-carcinoma-of-forearm-keratoacanthoma-dermatopathology

HISTORY 74-year-old man presents with 3-month history of painful lesion of the right forearm.  Biopsy found cystic squamous cell carcinoma with deep margins involved. Wide local excision was performed achieving clear margins. DISCUSSION Cystic degeneration within squamous cell carcinoma of the skin is not considered an especially malignant finding. These histologic findings may represent changes…

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Anticoagulant Use in Cutaneous Surgery

anticoagulant-use-in-cutaneous-surgery-scalp-squamous-cell-carcinoma-Mohs-and-reconstruction

HISTORY 87-year-old man with atrial fibrillation presented with squamous cell carcinoma in situ of scalp and forehead. Patient was treated with Mohs and reconstruction on 7-3-18. Incisional hematomas appeared 2.5 weeks post Mohs and treated with I&D. Patient continued warfarin and baby aspirin throughout treatments. DISCUSSION Anticoagulant use in Facial and Dermatologic Surgeries has become…

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Recurrent SCC of Nasal Tip

Recurrent-SCC-nose-rhinectcomy-mapping-biopsy-SCARS-center-Mohs-excision-infiltrative-squamous-cell

HISTORY 71-year-old man presents with recurrence of SCC of nose following Mohs excision on 2-9-17. Partial rhinectomy was performed with incomplete Mohs excision leaving residual positive margins due to patient’s comfort.  Two additional excisions of involved margins were done under anesthesia achieving clear margins. First stage reconstruction was performed on 4-11-18. DISCUSSION Management of a…

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SCC of Scalp

SCC-Scalp-Newport-Beach-Mohs-and-Reconstruction-perineural-invasion

HISTORY 86-year-old man presents with 3-month history of a mass in the left occipital scalp. 1 year prior, the patient underwent Mohs excision of a large scalp SCC.  FNA biopsy on 1-22-18 found atypical squamous cells. CT PET scan showed cancer limited to the mass itself with no lymph node enhancement. Patient experienced progressively increasing…

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Dysplasia of Lower Lip

Dysplasia-lower-lip-actinic-cheilitis-skin-cancer-SCC

HISTORY 51-year-old man presents with one-year history of lower lip nonhealing lesion. The patient has a many year history of extensive sun exposure with scaling and crusting.  A biopsy of the nonhealing lesion showed leukokeratosis with minimal keratinocytic atypia. Excisional biopsy done 11-1-17 showed moderate to focally severe squamous atypia. The patient was then treated…

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Multiple Skin Cancers in an Organ Transplant Recipient

Treatment for Multiple Skin Cancer Patients

HISTORY 71-year-old organ transplant recipient presents with several SCC’s of scalp and face. Mohs excisions and closures were performed.  Tissue of the left temple incidental to reconstruction was submitted for histologic analysis. Incidental BCC was found in the specimen requiring additional treatment. 4 to 6 o’clock margin was involved.   The patient with bilateral kidney…

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Recurrent SCC of Nasal Tip

Recurrent-SCC-of-Nasal-Tip-Orange-County-Skin-Cancer

HISTORY 71-year-old man presents with recurrence of SCC of left nose. Mohs excision of left nasal tip SCC was performed on 2-9-17. Left nasal fullness under flap, initially thought to be a scar, progressed until drainage appeared. Pathology of draining debris under flap showed invasive squamous cell carcinoma.  Intranasal mapping biopsies were performed on 2-12-18.…

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Forehead SCC with Perineural Invasion

Skin-Cancer-And-Reconstructive-Surgery-Foundation-Forehead-SCC-with-perineural-invasion-Beam’s-eye-view

HISTORY   83-year-old man presented in 02/2017 with a 3-year history of a forehead and temple SCC. The cancer was initially treated with cryoablation and 5-FU. Excision on 9/2/16 was performed with residual circumferential margins. Histology found poorly differentiated sclerosing squamous cell carcinoma, with perineural invasion of 0.1 mm nerves.  Wide local resection with radial…

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Scalp SCC Metastasis to Neck

Skin-Cancer-And-Reconstructive-Surgery-Foundation-Scalp-SCC-Metastasis-to-neck-CT-PET-scan

HISTORY   64-year-old man presents in 11/2017 with tender, right postauricular swelling. Fine needle aspiration biopsy showed squamous cell carcinoma. Extensive squamous cell carcinoma of scalp was treated with 4 levels of Mohs earlier that year in 01/2017. Additional smaller squamous cell carcinoma of the same area of the scalp was treated with Mohs in…

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