Squamous Cell Carcinoma Presenting Research Articles

Cutaneous Squamous Cell Carcinoma Presenting as Cellulitis

Cutaneous Squamous Cell Carcinoma Presenting as Cellulitis

Cutaneous Squamous Cell Carcinoma Presenting as Cellulitis

Cutaneous Squamous Cell Carcinoma Presenting as Cellulitis

An Unusual Presentation of Squamous Cell Carcinoma in a Never Smoker: A Case Report

Lung Cancer is one of the most common types of cancer found among smokers. However, approximately 10% of lung cancer patients are non-smokers. Non-smokers are frequently seen developing Adenocarcinoma, a type of non-small cell carcinoma with a female predominance. The incidence of Squamous cell carcinoma among non-smokers is very low. Moreover, studies have shown that tetra site metastasis in the case of Squamous cell carcinoma of the lung is almost as rare as 0.6% [1]. The authors report here in this article a case report of a rare and aggressive presentation of Squamous cell carcinoma in a non-smoker. This is a case of a 50-year-old male patient who is a non-smoker, presented with complaints of exertional dyspnoea and cough with expectoration for 3 months which had aggravated since 15 days, associated with hoarseness of voice and diffuse headache since 15 days. There was a history of significant weight loss and loss of appetite for 3 months. CECT thorax revealed a heterogeneously enhancing mass lesion in the anterior segment of the left upper lobe encasing the left pulmonary artery with evidence of liver, adrenal and vertebral metastasis. During the hospital stay, the patient developed complete ptosis of the right eye. MRI brain was done which showed features suggestive of metastasis involving bilateral cerebral and cerebellar hemispheres. USG guided lung biopsy was done and was suggestive of moderately differentiated Squamous cell carcinoma. The patient was planned to be further worked up for IHC markers and PET CT scan to determine the further line of treatment however, unfortunately, the patient succumbed to the disease within 1 week of histopathological diagnosis.

Unusual Presentation of Squamous Cell Carcinoma in a Young Male: Clinicopathological Insights and Considerations

Unusual Presentation of Squamous Cell Carcinoma in a Young Male: Clinicopathological Insights and Considerations

Conjunctival Squamous Cell Carcinoma Presenting after Chemical Burn Injury

Conjunctival Squamous Cell Carcinoma Presenting after Chemical Burn Injury

Prognostic risk factors of buccal squamous cell carcinoma: A case-control study.

To describe the clinicopathologic presentation of buccal squamous cell carcinoma and identify risks factors for recurrence and overall survival. This is a retrospective case-control study of patients with oral cavity squamous cell carcinoma (OCSCC) treated at a single tertiary care center between 2010 and 2022. All patients with buccal subsite OCSCC treated during this time frame were included and paired with a randomly selected age and gender matched patient with non-buccal OCSCC. Relevant data was collected via chart review. Seventy-seven patients with buccal SCC were matched with 77 non-buccal OCSCC controls. The median follow-up time was 27 months (IQR 14-61). Median age was 67 years (IQR 57-75) and 53% of the cohort was female. Twenty (26%) buccal SCC patients experienced a recurrence versus 19 (25%) in the controls. Age ≥65-years-old increased odds of all-cause mortality in the buccal SCC group, but not in the control group. Perineural invasion and positive margins increased odds of recurrence in the buccal group only. Overall survival and progression-free survival did not differ between the groups, despite a greater number of T2 buccal tumors and T1 non-buccal tumors. Buccal SCC presents at a higher T stage than other oral cavity SCC subsite and may exhibit variance in the pathologic risk factors that predict poor outcomes versus non-buccal OCSCC. Despite these relatively minor differences, however, oncologic outcomes between these groups were similar.

Association between spatial distribution of leukocyte subsets and clinical presentation of head and neck squamous cell carcinoma.

Interactions between tumor cells and cells in the microenvironment contribute to tumor development and metastasis. The spatial arrangement of individual cells in relation to each other influences the likelihood of whether and how these cells interact with each other. This study investigated the effect of spatial distribution on the function of leukocyte subsets in the microenvironment of human head and neck squamous cell carcinoma (HNSCC) using multiplex immunohistochemistry (IHC). Leukocyte subsets were further classified based on analysis of two previously published HNSCC single-cell RNA datasets and flow cytometry (FC). IHC revealed distinct distribution patterns of leukocytes differentiated by CD68 and CD163. While CD68hiCD163lo and CD68hiCD163hi cells accumulated near tumor sites, CD68loCD163hi cells were more evenly distributed in the tumor stroma. PD-L1hi and PD-1hi cells accumulated predominantly around tumor sites. High cell density of PD-L1hi CD68hiCD163hi cells or PD-1hi T cells near the tumor site correlated with improved survival. FC and single cell RNA revealed high variability within the CD68/CD163 subsets. CD68hiCD163lo and CD68hiCD163hi cells were predominantly macrophages (MΦ), whereas CD68loCD163hi cells appeared to be predominantly dendritic cells (DCs). Differentiation based on CD64, CD80, CD163, and CD206 revealed that TAM in HNSCC occupy a broad spectrum within the classical M1/M2 polarization. Notably, the MΦ subsets expressed predominantly CD206 and little CD80. The opposite was observed in the DC subsets. The distribution patterns and their distinct interactions via the PD-L1/PD-1 pathway suggest divergent roles of CD68/CD163 subsets in the HNSCC microenvironment. PD-L1/PD-1 interactions appear to occur primarily between specific cell types close to the tumor site. Whether PD-L1/PD-1 interactions have a positive or negative impact on patient survival appears to depend on both the spatial localization and the entity of the interacting cells. Co-expression of other markers, particularly CD80 and CD206, supports the hypothesis that CD68/CD163 IHC subsets have distinct functions. These results highlight the association between spatial leukocyte distribution patterns and the clinical presentation of HNSCC.

Case – Late Presentation of Invasive Keratinizing Squamous Cell Carcinoma

Penile cancer, a rare but highly morbid disease, primarily manifests as squamous cell carcinoma (PSCC) originating from the squamous cells of the glandular and preputial skin. Late-stage diagnosis is common due to social stigma, psychological barriers, and nonspecific initial symptoms, resulting in poor overall survival rates, especially in metastatic cases. This case report illustrates a 38-year-old man with advanced metastatic PSCC, showcasing severe systemic manifestations and delayed presentation of the disease. Despite aggressive treatment options, the patient opted for palliative care, succumbing to the disease months after his diagnosis. Risk factors for PSCC include HPV infection, phimosis, chronic inflammation, and lifestyle factors, with higher prevalence in regions of low socioeconomic status. The psychological and sexual burden of penile cancer is significant, impacting patients’ well-being, mental health, and quality of life. In conclusion, efforts to reduce the stigma associated with penile cancer are crucial to prompt early diagnosis and treatment initiation. Encouraging seeking medical attention for symptoms can enhance the chances of recovery and minimize the need for invasive treatments. Addressing the psychosocial impact of the disease is imperative for holistic patient care.

Distant metastasis at the time of presentation of head and neck squamous cell carcinoma: a retrospective chart review from a tertiary cancer care centre.

To evaluate the rates and patterns of distant metastasis in head and neck SCC at the time of presentation and to study the association between distant metastasis with pre-treatment, clinical, and pathological predictors of outcomes. This is a retrospective study conducted in a tertiary care hospital. All patients with primary head and neck squamous cell carcinoma that had been evaluated at our institute between October 2018 and December 2020 were included in the study. Various clinical data were analysed and pattern of metastasis was studied. Ten per cent (50 cases) of 501 studied patients had distant metastasis. The most common site of distant metastasis was lung. The rate of distant metastasis was high in patients with poorly differentiated cancers. By Kaplan-Meier analysis, the median survival duration after diagnosis of metastasis was four months. The rate of distant metastasis was 10 per cent in the study. Patients with poorly differentiated tumours, locally advanced primary lesions, higher nodal stage, particularly with extra nodal extension, and hypopharyngeal primary, tend to exhibit increased risk for distant metastasis at the time of presentation.

Squamous Cell Carcinoma in the Oral and Maxillofacial Region: A 12-Year Analysis at a Tertiary Healthcare Facility from North-Western Nigeria

Background: Orofacial cancers remain a serious burden in developing countries largely due to scarcity of resources in both diagnosis and treatment. This study aimed to present the pattern of clinical presentation and management of squamous cell carcinoma (SCC) of the oral and maxillofacial region at a tertiary health care facility, Northwestern Nigeria.
 Materials and Methods: This study was a retrospective analysis of cases of squamous cell carcinoma of the oral and maxillofacial regionseen in the past 12 years (January 2012 to January 2023). After obtaining ethical approval from the research and ethics committee of the institution, patients’ demographic characteristics, risk factors, sites, stage, histologic diagnosis, and treatment status were extracted from the patient's record. The data were analyzed using IBM SPSS version 25 software.
 Results: A total of 233 cases (114 (76.8%) males and 54 (23.2%) females) were analyzedin the age range of 20-80 years with a mean±SD of 52.98±16.08years. Most of the patients 174(74.7%) were farmers. The onset ranged from 6 weeks to 2 years. The main complaint of the patients were pain and swelling (132 (56.7%)). Extensive or multiplesites (72 (30.9%)) constitute the majority of the SCC. Well-differentiated SCC (133 (57.1%)) was the predominant diagnosis and, the majority (86 (36.9%)) were Stage IV lesions. The male patients were found to have more advanced disease compared to females with a statistically significant difference (p= 0.000). Surgery+ referral for chemotherapy/radiotherapy (125(57.1)) was the main treatment modality.
 Conclusion: The well-differentiated SCC was thecommonest histologic subtype. Surgery and chemoradiation therapy were treatment modalities offered the patients especially with the early lesions and prompt initiation of treatment.

The impact of the pandemic on the presentation and treatment of head and neck squamous cell carcinoma at a county hospital

IntroductionIn March 2020, the World Health Organization declared COVID-19 a pandemic, initiating stay-at-home orders which delayed cancer care and screening. The impact on head and neck cancer care in populations at risk has yet to be elucidated. The objective of this investigation is to evaluate how the presentation, diagnosis, and treatment of head and neck squamous cell carcinoma cancer patients at a county hospital were affected by the pandemic. MethodsA retrospective review of patients with head and neck squamous cell carcinoma that were diagnosed at a county hospital 365 days before and after stay-at-home orders were initiated. The primary outcomes were duration between diagnosis from imaging and initiation of treatment. Secondary outcomes included mortality, stage, nodal status, and distant metastasis at presentation. ResultsThere was a total of 105 diagnoses. Sixty-five (62 %) head and neck squamous cell carcinoma diagnoses were diagnosed before the stay-at-home orders were initiated, and 40 (38 %) after. Eighty percent (32/40) of diagnoses presenting after had stage IV disease compared to 58 % (38/65) in those before (p < 0.05). A higher percentage of patients who presented later had a >30-day delay to biopsy (43 % v. 20 %, OR: 3.0, p < 0.05). This difference was exacerbated by those with laryngeal, oral cavity, or oropharyngeal cancer (45 % v. 15 %, OR: 4.5, p < 0.05). There was a larger delay from diagnosis to treatment after the orders were initiated (68 v. 53, p < 0.05) however there was no difference in one-year mortality (25 % v. 23 %, p > 0.05). This investigation found a 14 % loss to follow-up. Conclusions and relevanceIn this cohort of head and neck squamous cell carcinoma diagnoses at a county hospital, those diagnosed after the stay-at-home orders were initiated presented with more advanced disease. They also had more delays in diagnosis and initiation of treatment. There was no difference in one-year mortality rates between the two groups however there was a significant loss to follow-up, limiting prognostication. These findings serve to better prepare healthcare providers to implement optimized care during future shutdowns related to public health crises. Level of evidenceIII

S2116 Rare Primary Pancreatic Squamous Cell Carcinoma Presenting as Duodenal Obstruction

S2116 Rare Primary Pancreatic Squamous Cell Carcinoma Presenting as Duodenal Obstruction

A Squamous Cell Carcinoma Presenting As A Persistent OAC

A Squamous Cell Carcinoma Presenting As A Persistent OAC

1099 Tonsillar Carcinoma Metastasis to the Central Nervous System: Case Report and Literature Review

Abstract We present a case report of a 51-year-old left-handed male with a background of human papillomovairus 16-positive tonsil squamous cell carcinoma presenting with tonic-clonic seizures and a radiological diagnosis of secondary CNS metastatic deposits. These were initially treated with stereotactic radiosurgery and subsequently with surgery. Surgical resection was performed under general anesthesia with right-sided temporal and parietal approaches. Both the parietal and temporal deposits were removed, while the intraventricular mass was intentionally left to avoid postoperative deficits. Adjuvant radiotherapy and chemotherapy were administered postoperatively. The patient experienced a satisfactory post operative recovery. However, he was reoperated for recurrence 4 months later. He maintained a good quality of life and an excellent performance status throughout, but unfortunately, he passed away in November 2018 due to septic complications. This case history stresses the difficulty in managing oropharyngeal squamous cell carcinomas (SCC) with brain metastatic deposits. There are no current guidelines regarding the management of patients presenting with such a rare condition. Additionally, we performed a literature review and describe the limited previous cases within the literature. More data is thus desirable to better define treatment guidelines and protocols when tonsillar SCC brain metastases are present.

Insurance Status is Associated With Recurrence in Cutaneous Head and Neck Squamous Cell Carcinoma.

To identify socioeconomic factors influencing the presentation and outcomes of cutaneous head and neck squamous cell carcinoma (cHNSCC). Retrospective cohort study. Tertiary academic medical center with comprehensive cancer center. Patients treated for cHNSCC at a single institution between 2008 and 2022 were included. Demographic, socioeconomic data and disease characteristics were obtained from medical record abstraction. Outcome measures included tumor stage, number of distinct primaries, recurrence, and disease-related death. χ2 and Mann-Whitney tests were implemented to evaluate clinicopathologic distributions across disease stages. Survival analyses were performed using Cox regression and Kaplan-Meier analysis. A total of 346 patients met the inclusion criteria. The median age at presentation and length of follow-up was 70.8 and 3.1 years, respectively. The majority of the cohort was white, male, and English-speaking. 13.3% of patients were underinsured and 27.5% were immunosuppressed. Patients who presented with advanced disease were more likely to be underinsured (21.7% vs 9.6%, P = .006) and have a history of homelessness (8.5% vs 2.1%, P = .014). Immunosuppressed patients were more likely to be underinsured (P = .009). Insurance status (1.97 [1.06-3.66],P = .032) and immune status (2.35 [1.30-4.26],P = .005) were independently associated with worse recurrence-free survival. Socioeconomic factors that influence access to care, such as insurance status, are associated with cHNSCC disease stage and disease recurrence. These factors may impose barriers that delay diagnosis and treatment. This may result in worse disease-related outcomes and greater treatment-associated morbidity for certain patients.

Oral Squamous Cell Carcinoma Presenting as a Stiff Tongue.

Oral Squamous Cell Carcinoma Presenting as a Stiff Tongue.

An Unusual Presentation of Squamous Cell Carcinoma of Head and Neck Region

An Unusual Presentation of Squamous Cell Carcinoma of Head and Neck Region

Unusual Clinical Presentation of Cutaneous Squamous Cell Carcinoma: a Retrospective Study in Al Baha Region, Southern Saudi Arabia

Cutaneous squamous cell carcinoma (cSCC) is the second most common non-melanoma skin cancer, and it accounts for 20% of all skin cancers. It occurs typically on parts of the skin exposed to sunlight and begins as firm erythematous papules or nodules that enlarge over a period of months in most cases. This study investigates the unusual presentation of cSCC with the goal of raising awareness of rare presentations and promoting accurate diagnostic tools. It is a five-year retrospective study retrieving patient data to study the demographic, clinical and histological features of cSCC with unusual presentations that were clinically unsuspected. It was carried out in Al Baha Province, southern Saudi Arabia. A total of 25 cases were included; males predominated (60%), and the mean age of the cohort was 59.8 years. However, three patients were &lt;50 years old and the most prevalent site of the cSCC was the nose. Tumor size ranged from 5 to 50 mm with a mean size of 14.6 mm. Tumor size was uncorrelated with a clinical suspicion of malignancy. The clinical presentation of cSCC varies from tan nodules in most cases (28%) to warty lesions in 4% of cases; the clinical diagnosis of such lesions also varied from highly malignant lesions (melanoma) to a simple inflammatory disease. Histologically, most cases (96%) were keratinizing squamous cell carcinomas. A clinical suspicion of cSCC is not always accurate, and histopathology is the most accurate tool for diagnosis. Abdominal wall, perianal and finger sites are not immune to cSCC, and young individuals are also at risk.

Bilateral lower limb squamous cell carcinoma a rare case

Cutaneous squamous cell carcinoma is a malignant tumour of the keratinising cells of epidermis or its appendages. It constitutes of 20% of skin malignancy. UV radiation exposure is the most common cause of skin cancer with sun exposed skin of the face and upper trunk being the common site for occurrence. Long term exposure to chemical carcinogen, burn scar, chronic ulcer is among the other risk factors. Skin biopsy is the mainstay of diagnosis in a suspected lesion of SCC. Most SCC can be treated with local excision with margin of 5 mm and a margin of around 10 mm in high risk lesion. Other treatment modalities which do not define the margin status such as radiation therapy, cryosurgery, photodynamic therapy, electro dissection, topical agents like imiquimod can be used in small superficial lesions. The following is a case of 32-year-old male patient with atypical presentation of bilateral lower limb squamous cell carcinoma.

Clinical Presentation of Wide Field of Cancerization Associated with Oral Squamous Cell Carcinoma.

The late presentation of oral squamous cell carcinoma (OSCC) patients in Sudan, with advanced stages and wide field of cancerization (WFC), has a negative impact on these patients. The present study aimed to investigate the different clinical presentations of mucosal changes in WFC associated with OSCC in Sudanese patients. This a prospective longitudinal study of 93 OSCC cases. Tumor's associated field of cancerization was identified and related clinical mucosal changes were described. Out of the 93 patients, 57 (61.3%) were males and 36 (38.7%) were females. Eighty-two percent of the patients presented with stage IV tumors. Ninety-two patients had multiple sites involved in the oral cavity with overlap of sites involved. The Gingivobuccal mucosa (74.2%) was the most frequent site involved. Eighty-three (89.2%) of the lesions were surrounded by mucosal changes, of them 32 (38%) surrounded by a grizzle (mixed dark and white) discoloration and 21 (26%) were surrounded by a white-smoke discoloration followed by 17 (20%) and 13 (16%) surrounded by cotton-white and Café au lait discolorations, respectively. Forty-four (47.3%) lesions had overlapping presentations and surrounded by erythematous patches. The present study showed that OSCC patients in Sudan present with advanced lesions, mostly associated with WFC, particularly the Toombak dippers. The different mucosal changes seen in the WFC associated with OSCC in these cases are in accordance with the known five mucosal presentations.