A Clinicopathological Observation of Cutaneous Squamous Cell Carcinoma and Metastasis (2006~2016)

Song, Sung eun; Ro, Ki woong; Heo, Eun phil

Abstract

BACKGROUND
Cutaneous squamous cell carcinoma (cSCC) is a malignant proliferation of keratinocytes of the epidermis. It may have the potential to metastasize distally in contrast to the cutaneous basal cell carcinoma.
OBJECTIVE
We investigated the recent trend of cSCC development from a clinical, histopathological, and prognostic perspective.
METHODS
One hundred and sixty cases of cSCC in patients who had visited the Samsung Changwon Hospital over the past 10 years (between 2006 and 2016) were retrospectively studied. We analyzed their age, sex, location, etiologic factor, histopathologic finding, and treatment.
RESULTS
The average age of cSCC was 77 years old and the sex ratio was 1:2.27. The most commonly involved location was the head and neck (73.13%). The etiologic factors were unknown (61.88%), actinic keratosis (23.13%), Bowen's disease (10.63%), burn scar (2.5%), chronic eczema (0.63%) and chronic inflammatory disease (0.63%). The average tumor diameter and thickness were 18.1 mm and 3.58 mm, respectively. The degrees of differentiation were well-differentiated (68.75%), moderately differentiated (28.75%) and poorly differentiated (2.5%). The occurrence rate of cSCC metastasis was 6.25% (10 cases/160 cases). The most common primary locations of cSCC metastasis were the lower extremities (5 cases/10 cases) and head and neck (2 cases/10 cases). All 10 cases were metastasis to adjacent lymph nodes. Five cases showed metastasis to distant lymph nodes, the lungs, liver or bone. The average tumor diameter and thickness of cSCC metastasis were 45.3 mm and 9.46 mm, respectively. Histopathologically, the degrees of differentiation were well-differentiated, moderately differentiated and poorly differentiated type (4 cases, 5 cases, and 1 case, respectively).
CONCLUSION
The location of the lower extremities (p=0.000) and a size larger than 20 mm (p=0.000) were related to cSCC metastasis. cSCC metastasis was found at an average of 7.5 months after diagnosis. High-risk cSCC patients should be followed closely, particularly during the first 2 years after diagnosis.