Multiple Cutaneous Squamous Cell Carcinomas Research Articles

Multiple cutaneous squamous cell carcinoma of the forehead in a patient with skin of color treated by wide local excision with adjuvant radiotherapy: a case report

Cutaneous squamous cell carcinoma is the second most common non-melanoma skin cancer, characterized by the proliferation of keratinocytes, with an increasing incidence worldwide. In cases of perineural invasion, surgical excision followed by adjuvant radiotherapy is the preferred treatment. An intraoperative frozen section is necessary to determine the cancer-cell-free margin. A 80-year-old male presented to the outpatient department of our hospital with two fungating growths over his right forehead (size 2.7×1.2 cm) and right temple region (size 4×1.2 cm) for 5 years. An incisional biopsy of the growths revealed well-differentiated squamous cell carcinoma. There was no evidence of lymphadenopathy. The patient was treated successfully by wide local excision of the growths with an intraoperative frozen section to determine negative margins. Local defects of the forehead and right temple were reconstructed with a scalp rotation flap and a split skin thickness graft, respectively. The final histopathological examination showed moderately differentiated squamous cell carcinoma with resection-free margins. Forehead growth showed perineural invasion. The patient underwent 30 fractions of image-guided adjuvant radiotherapy in view of perineural invasion and to avoid local recurrence. The patient recovered well without any recurrences or complications. Surgical excision and reconstruction followed by adjuvant radiotherapy is the most effective method for treating cutaneous squamous cell carcinomas with perineural or lymphovascular invasion. Intraoperative frozen section is necessary to reduce recurrence rates and metastasis. Ours is a rare case of multiple cutaneous squamous cell carcinomas involving the forehead region.

Ulcerated Scar-Like Plaque After Localized Radiation Therapy in a Patient With Multiple Prior Cutaneous Squamous Cell Carcinomas: Answer.

Ulcerated Scar-Like Plaque After Localized Radiation Therapy in a Patient With Multiple Prior Cutaneous Squamous Cell Carcinomas: Answer.

Ulcerated Scar-Like Plaque After Localized Radiation Therapy in a Patient With Multiple Prior Cutaneous Squamous Cell Carcinomas: Challenge.

Ulcerated Scar-Like Plaque After Localized Radiation Therapy in a Patient With Multiple Prior Cutaneous Squamous Cell Carcinomas: Challenge.

Variable Outcome of Immunotherapy in Advanced Multiple Cutaneous Squamous Cell Carcinomas in Two Patients with Recessive Dystrophic Epidermolysis Bullosa

Cutaneous squamous cell carcinoma (cSCC) is a major complication of recessive dystrophic epidermolysis bullosa (RDEB) that has high morbidity and mortality rates and unmet therapeutic needs. The aim of this study was to evaluate the molecular pattern of cSCC and the clinical course of immunotherapy in 2 RDEB patients with multiple advanced cSCC. Clinical course and disease staging were evaluated retrospectively. The tumour tissues were subjected to immunohistochemical staining. DNA from the blood and cSCC samples was subjected to massive parallel sequencing, and somatic mutations were determined. Patient 1 survived for over 2 years as disease control was achieved with cemiplimab and intralesional interleukin-2. The target advanced cSCC demonstrated a high rate of somatic mutations and strong expression of the immune markers, indoleamine 2,3-dioxygenase, programmed cell death protein ligand 1, and lymphocyte-activation gene 3. The patient ultimately succumbed to complications of oesophageal carcinoma. Patient 2 had an undifferentiated cSCC on the foot, which displayed a low mutational burden and did not express immune markers. The tumour progressed quickly even with cemiplimab therapy. These 2 cases underscore the challenges of cSCC treatment for RDEB. Multiple tumours with different molecular and immune profiles occur concomitantly or sequentially, and surgical excision is not always possible because of the anatomical and tissue constraints imposed by the disease itself. In conclusion, programmed cell death protein 1 inhibitors are approved and effective in treating metastatic and locally advanced cSCC. Our experience and the literature suggest that cemiplimab is an option in patients with RDEB if surgery is not. Somatic mutations and the immune microenvironment should be characterized to predict therapeutic response, particularly in aggressive undifferentiated tumours.

Host and primary tumor factors for the development of multiple cutaneous squamous cell carcinomas among a retrospective cohort in Rhode Island

Risk factors for a primary cutaneous squamous cell carcinoma (CSCC) are well-established; however, the host and primary tumor risk factors for subsequent CSCC have not been fully explored. We performed a retrospective chart review of patients diagnosed with CSCC in an academic dermatology clinic in Rhode Island from 2016-2019. Logistic regression was used to evaluate the associations between host factors and multiple CSCC and between primary tumor characteristics and the risk of subsequent CSCC. Adjusted odds ratios (aORs) and 95% CIs were calculated. A total of 1312 patients with CSCC diagnoses were included. Host risk factors significantly associated with multiple CSCCs included: aged >80years (aOR, 2.18; 95% CI, 1.46-3.31); history of: solid organ transplant (aOR, 2.41; 95% CI, 1.20-4.80); skin cancer (aOR, 1.96; 95% CI, 1.52-2.54); other cancer (aOR, 1.49; 95% CI, 1.11-2.00); family history of skin cancer (aOR, 1.36; 95% CI, 1.03-1.78); and actinic keratosis (aOR, 1.52; 95% CI, 1.18-1.95). Tumor location, diameter, histologic differentiation, and treatment were not significant predictors of subsequent CSCCs. Study patients were predominantly White and from a single institution, limiting the generalizability of results. Certain host characteristics were associated with the development of subsequent CSCC, which may inform clinical guidelines for follow-up.

34405 Host and primary tumor factors for the development of multiple cutaneous squamous cell carcinomas

Introduction: Risk factors for the development of a primary cutaneous squamous cell carcinoma (CSCC) are well-established, but risk factors for subsequent CSCCs are not. While history of prior CSCC is considered the single strongest predictor for development of subsequent CSCCs, the host and primary tumor risk factors at play have not been fully explored.

Skin reconstruction on exposed calvarium with Recell Therapy – Case report

<b>Introduction:</b> The management of exposed calvarium in certain patients can pose as a challenge to surgeons. Several methods of management of such defects have been described. However, these methods may not be suitable for certain cohort of patients due to increased frailty and their complex medical co-morbidities. Recell® System (Avita Medical) is a device that allows clinicians to harvest skin cells from patients' own skin under local anaesthetic. <b>Methods:</b> A 63-year-old male who initially presented with multiple cutaneous squamous cell carcinoma on his scalp. His medical co-morbidities include idiopathic thrombocytopenic purpura and non-insulin dependent diabetes. He was unfit for the procedure under general anaesthetic. He had excision of the lesions and reconstruction with a split thickness skin graft under local anaesthesia. Subsequently, the skin graft failed and left multiple extensive areas of exposed calvarium despite having a week course of prophylactic antibiotics. Due to his susceptibility to infections, we opted to reconstruct the defect with Recell therapy only under local anaesthesia. <b>Results:</b> The patient had surgery which involved bone debridement and harvesting skin cells with Recell device from the split thickness skin graft harvested from the left upper arm under local anaesthesia. The cells were delivered via a spray-on system onto the defect and dressed. The dressings were changed weekly until complete wound healing. Complete skin epithelisation was observed at 5 months post-operatively. <b>Conclusions:</b> Recell® therapy should be considered as an armamentarium of managing exposed bone in patients with multiple medical co-morbidities.

Incidence of Multiple vs First Cutaneous Squamous Cell Carcinoma on a Nationwide Scale and Estimation of Future Incidences of Cutaneous Squamous Cell Carcinoma

Until now, most studies on cutaneous squamous cell carcinoma (cSCC) incidence rates concerned only the first cSCC per patient. Given the increase in incidence rates and the frequent occurrence of subsequent cSCCs per patient, population-based data on the incidence rates of both first and multiple cSCCs are needed. To calculate annual age-standardized incidence rates for histopathologically confirmed first and multiple cSCCs per patient and to estimate future cSCC incidence rates up to 2027. A nationwide population-based epidemiologic cohort study used cancer registry data on 145 618 patients with a first histopathologically confirmed cSCC diagnosed between January 1, 1989, and December 31, 2017, from the Netherlands Cancer Registry and all patients with multiple cSCCs diagnosed in 2017. Age-standardized incidence rates for cSCC-standardized to the European Standard Population 2013 and United States Standard Population 2000-were calculated per sex, age group, body site, and disease stage. A regression model with positive slope was fitted to estimate cSCC incidence rates up to 2027. A total of 145 618 patients in the Dutch population (84 572 male patients [58.1%]; mean [SD] age, 74.5 [11.5] years) received a diagnosis of a first cSCC between 1989 and 2017. Based on incident data, European Standardized Rates (ESRs) increased substantially, with the highest increase found among female patients from 2002 to 2017, at 8.2% (95% CI, 7.6%-8.8%) per year. The ESRs for first cSCC per patient in 2017 were 107.6 per 100 000 person-years (PY) for male patients, an increase from 40.0 per 100 000 PY in 1989, and 68.7 per 100 000 PY for female patients, an increase from 13.9 per 100 000 PY in 1989, which corresponds with a US Standardized Rate of 71.4 per 100 000 PY in 2017 for men and 46.4 per 100 000 PY in 2017 for women. Considering multiple cSCCs per patient, ESRs increased by 58.4% for men (from 107.6 per 100 000 PY to 170.4 per 100 000 PY) and 34.8% for women (from 68.7 per 100 000 PY to 92.6 per 100 000 PY). Estimation of ESRs for the next decade show a further increase of 23.0% for male patients (ESR up to 132.4 per 100 000 PY [95% prediction interval, 125.8-139.0 per 100 000 PY]) and 29.4% for female patients (ESR up to 88.9 per 100 000 PY [95% prediction interval, 84.3-93.5 per 100 000 PY]). This nationwide epidemiologic cohort study suggests that incidence rates of cSCC keep increasing, especially among female patients, and that the occurrence of multiple cSCCs per patient significantly adds to the current and future burden on dermatologic health care. Revision of skin cancer policies are needed to halt this increasing trend.

Multiple cutaneous squamous cell carcinomas with confluent noncaseating epithelioid granulomas in PLCG2-associated antibody deficiency and immune dysregulation (PLAID) syndrome: A case report

Multiple cutaneous squamous cell carcinomas with confluent noncaseating epithelioid granulomas in PLCG2-associated antibody deficiency and immune dysregulation (PLAID) syndrome: A case report

Correlates of multiple cutaneous squamous cell carcinoma: A retrospective cohort study

Correlates of multiple cutaneous squamous cell carcinoma: A retrospective cohort study

210 Correlates of multiple cutaneous squamous cell carcinoma

210 Correlates of multiple cutaneous squamous cell carcinoma

Multiple Cutaneous Squamous Cell Carcinoma in Immunosuppressed vs Immunocompetent Patients

This case-control study examines the association of multiple squamous cell carcinoma with poor outcomes in the immunosuppressed patient population.

Discontinuing voriconazole induced no completely regression of multiple cutaneous squamous cell carcinoma in a hematopoietic stem cell transplant patient

Voriconazole is a universal anti-fungal prophylaxis, which is frequently taken to the patients after hematopoietic stem cell transplantation and solid organ transplantation. Voriconazole can cause phototoxicity, multiple erythema in sun-exposed areas may develop actinic keratosis and cutaneous squamous cell carcinoma (cSCC) while taking voriconazole. In North America and Europe, case reports of phototoxicity and aggressive cSCC in patients on voriconazole have been documented. Also 4 cases of voriconazole-associated cSCC have recently been reported in Japan. We describe a Japanese woman with multiple cSCC associated with recurrence of cSCC after discontinuing voriconazole.

Recent advances in field cancerization and management of multiple cutaneous squamous cell carcinomas.

Cutaneous squamous cell carcinoma (SCC) is among the most common cancers in humans, and many patients with SCC will develop multiple tumors within their lifetime. The field cancerization concept, originally proposed over 60 years ago, hypothesized that multiple primary cancers may arise simultaneously and coexist with subclinical precursor lesions within a defined field. Genetic sequencing of SCC and precursor lesions has identified what may be the earliest clonal proliferations in SCC development and confirmed that field cancerization in the skin is mediated by ultraviolet radiation. For patients with multiple SCCs and severe actinic damage, treatment of precursor lesions within a cancerized field can decrease the risk of subsequent cancer development. Sunblock is an effective intervention for field cancerization, even in patients with established disease. There is now direct evidence that field therapy with topical 5-fluorouracil is effective in reducing the incidence of subsequent SCC, and there is indirect evidence suggesting that topical imiquimod, topical ingenol mebutate, and photodynamic therapy are similarly effective. There is limited direct evidence to show that systemic acitretin or nicotinamide can decrease incident SCC in patients with field cancerization. In this review, an approach to the management of patients with multiple SCCs and field cancerization is presented along with the rationale to support field-directed therapy.

Multiple Cutaneous Squamous Cell Carcinomas Arising in Several Body Areas Except for the Face.

Multiple Cutaneous Squamous Cell Carcinomas Arising in Several Body Areas Except for the Face.

Antineoplastic effect of laser immunotherapy in mice with multiple cutaneous squamous cell carcinoma

Objective To evaluate the antineoplastic effect of laser immunotherapy in mice with multiple cutaneous squamous cell carcinoma (CSCC) . Methods Normal immunocompetent hairless SKH-1 mice were consecutively irradiated by ultraviolet rays to establish mouse models of multiple CSCC. Then, 20 CSCC-bearing mice were randomly and equally divided into 4 groups: laser group irradiated with an 808-nm near-infrared laser (1 W/cm2, 10 minutes) once every two weeks for a total of 3 sessions, laser immunotherapy group irradiated with an 808-nm near-infrared laser as above and topically treated with imiquimod cream once a day for 3 days before and after each session of irradiation, imiquimod group treated with imiquimod cream as in the laser immunotherapy group, and control group receiving no treatment. The volume of tumors was calculated, and their morphology as well as the survival of mice were observed after the treatment. The t test and Mantel-Cox log-rank test were used to compare the volume of tumors on the dorsum and survival rates of mice, respectively, on days 27 and 60 after the start of treatment. Another 12 CSCC-bearing mice were randomly and equally divided into the 4 groups mentioned above, and tumor tissues were resected from these mice for histopathological examination on day 5 after the first treatment. Results On day 27, the volume of tumors significantly increased in the control group and imiquimod group (both P 0.05) . Moreover, the volume of tumors in the control group was slightly larger than that in the imiquimod group (P > 0.05) , but significantly larger than that in the laser group and laser immunotherapy group (both P 0.05) , significantly longer in the laser group and laser immunotherapy group compared with the control group (both P 0.05) . Histopathological examination showed that 5-day topical application of imiquimod cream did not cause death of tumor cells, but numerous tumor cells died in the laser group and laser immunotherapy group. Multiple inflammatory cells were observed around the tumors, and the number of the inflammatory cells was obviously larger in both the laser group and laser immunotherapy group, especially in the latter group, compared with the control group. Conclusion Laser immunotherapy is a new effective and safe treatment for CSCC in mice, and has potential value especially in the treatment of multiple or metastatic CSCC. Key words: Neoplasms, squamous cell; Laser; Immunity; Mice

Histopathologic features of multiple cutaneous squamous cell carcinomas of the lower extremity.

Recent studies suggest cutaneous squamous cell carcinomas (SCCs) of the leg, particularly those occurring multiply in sun exposed skin of nonimmunosuppressed women, are a distinct clinical subtype. There are few reports of the histopathologic features of this subtype. A retrospective chart review of 4 patients with multiple SCCs on the leg was performed and a total of 35 biopsies from the legs examined. Histopathologically, the tumors lacked adjacent actinic keratosis (AK) and often had adjacent basaloid retiform proliferations. Most lesions (all but one) were well differentiated and about 40% could be classified histopathologically as keratoacanthoma. Perineural invasion was absent in all but one case. Using the American Joint Committee on Cancer (AJCC) staging criteria for SCC, 21 tumors were Stage I, and 9 Stage II. During 7-10 years of follow-up, no recurrence or metastasis occurred. Patients with multiple SCCs on the lower extremities can have a range of histopathologic features, from keratoacanthoma-like to well-differentiated SCC.

Outcomes of Patients With Multiple Cutaneous Squamous Cell Carcinomas.

Outcomes of Patients With Multiple Cutaneous Squamous Cell Carcinomas.

Outcomes of Patients With Multiple Cutaneous Squamous Cell Carcinomas: A 10-Year Single-Institution Cohort Study.

Patients with multiple cutaneous squamous cell carcinomas (CSCCs) pose a management challenge for physicians, but their prognosis is unknown because outcomes have not been compared between patients who form single vs multiple CSCCs. To compare outcomes in patients with 1 vs multiple CSCCs. A 10-year retrospective single-institution cohort study at an academic tertiary care center of patients with dermally invasive (non-in situ) primary CSCC diagnosed from January 1, 2000, through December 31, 2009. Electronic medical records were reviewed to determine the tumor stage (Brigham and Women's Hospital tumor stage) and outcomes (local recurrence [LR], nodal metastases [NM], and death due to CSCC). Outcomes were compared between patients with 1 vs more than 1 CSCC via multivariable competing-risk regression adjusted for other significant cofactors. Of 985 patients with CSCC, 727 had 1 CSCC, 239 had 2 to 9 CSCCs, and 19 had 10 or more CSCCs. Most patients with 10 or more CSCCs were immunosuppressed (15 of 19 [78.9%]). The median follow-up time was 50 months (range, 2-142 months). Patients with more than 1 CSCC had a higher risk of LR (subhazard ratio for 2-9 CSCCs, 1.8; 95% CI, 1.1-4.3; and for ≥10 CSCCs, 3.8; 95% CI, 1.4-10.0) and NM (subhazard ratio for 2-9 CSCCs, 3.0; 95% CI, 1.4-6.5; and for ≥10 CSCCs, 4.2; 95% CI, 1.4-10.4) compared with patients with 1 CSCC, adjusted for Brigham and Women's Hospital tumor stage. The 10-year cumulative incidence of LR and NM was higher in patients with 2 to 9 CSCCs and markedly higher in those with 10 or more CSCCs compared with patients who had 1 CSCC (10-year cumulative incidence for 1 CSCC: LR, 3.0%; 95% CI, 2.0%-4.5%; and NM, 2.3%; 95% CI, 1.5%-3.8%; for 2-9 CSCCs: LR, 6.7%; 95% CI, 4.2%-10.6%; and NM, 5.9%; 95% CI, 3.5%-9.6%; and for ≥10 CSCCs: LR, 36.8%; 95% CI, 19.2%-59.0%; and NM, 26.3%; 95% CI, 11.8%-48.8%). Patients with multiple CSCCs warrant frequent follow-up because they have an elevated risk of LR and NM. In particular, patients with 10 or more CSCCs have markedly elevated risks of recurrence and metastasis.

Complete genome sequence of canine papillomavirus type 16.

Papillomaviruses are epitheliotropic, circular, double-stranded DNA viruses within the family Papillomaviridae that are associated with benign and malignant tumors in humans and animals. We report the complete genome sequence of canine papillomavirus type 16 identified within multiple pigmented cutaneous plaques and squamous cell carcinoma from an intact female Basenji dog.