Basal and Cutaneous Squamous Cell Carcinoma of the Head and Neck

Abstract

Basal cell carcinoma (BCC) is the most commonly diagnosed skin cancer in the United States and are most frequently encountered on sun-exposed body sites including the head and neck. They can be difficult to distinguish from other common skin neoplasms making biopsy a necessity for diagnosis prior to treatment. These tumors grow contiguously, are locally destructive but rarely metastasize making them good candidates for local surgical removal or destruction. This chapter reviews BCC epidemiology, pathogenesis, diagnostic approach and management considerations. Advanced tumors and practical considerations for plastic surgeons caring for these patients are also covered in detail. Squamous cell carcinoma (SCC) is the second most common malignancy of the skin. Most cases can be directly attributed to ultraviolet radiation (UVR), usually due to chronic sun exposure. With early detection, squamous cell carcinoma can be successfully treated with limited morbidity and low risk of mortality. Surgical modalities, namely Mohs micrographic surgery or wide local excision, are the gold standard for most invasive SCC. Advanced or particularly aggressive tumors carry a significant risk of local recurrence, nodal metastasis, and mortality. These risks highlight the importance of early detection, and appropriate risk stratification to guide the most appropriate treatment. This review contains 5 figures, 6 tables, and 63 references. Keywords: nonmelanoma skin cancers (NMSC), keratinocyte carcinomas (KC), basal cell carcinomas (BCC), squamous cell carcinomas (SCC), ultraviolet radiation (UVR), verrucous carcinoma, electrodesiccation and curettage (ED&C), photodynamic therapy (PDT), sentinel lymph node biopsy (SLNB), Brigham and Womens’s (BWH) tumor staging system