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1、SquamousCellCarcinomaAuthor:DebjaniSahni,MBBS,MRCP,CutaneousOncologyFellow,BrighamandWomen'sHospital,DanaFarberCancerInstituteCoauthor(s):ChrysalyneDSchmults,MD,InstructorinDermatology,HarvardMedicalSchool;Director,MohsMicrographicSurgeryCenter,DepartmentofDermatology,BrighamandWome
2、n'sHospitalContributorInformationandDisclosuresUpdated:Mar18,2009IntroductionBackgroundCutaneoussquamouscellcarcinoma(SCC)isthesecondmostcommonformofskincancerandaccountsfor20%ofcutaneousmalignancies.1Squamouscellcarcinomafrequentlyarisesonthesun-exposedskinofmiddle-agedandelderlyin
3、dividuals.Mostsquamouscellcarcinomasarereadilyidentifiedandremovedinthephysician'sofficeasaminorsurgicalprocedure.Largerandmoreinvasivelesionsmayrequireaggressivesurgicalmanagement,radiationtherapy,orboth.High-risksquamouscellcarcinomacarriesasignificantriskofmetastasisand,assuch,re
4、quirescarefulevaluationandtreatment.Generalriskfactorsassociatedwiththedevelopmentofsquamouscellcarcinomaareasfollows2,3,4,5,6,7,8:·Ageolderthan50years·Malesex·Lightskin;blondeorlightbrownhair;green,blue,orgrayeyes·Skinthatsunburnseasily(FitzpatrickskintypesIandII)·Geography(closert
5、otheequator)·Historyofpriornonmelanomaskincancer·ExposuretoUVlight(highcumulativedoseofsunshine,tanningbeds,ormedicalUVtreatments)·Exposuretochemicalcarcinogens(eg,arsenic,tar)·Exposuretoionizingradiation(medicaltreatments,occupationaloraccidentalradiationexposure)·Chronicimmunosupp
6、ression·Chronicscarringconditions·Certaingenodermatoses·Humanpapillomavirus(HPV)infection(specificsubtypes)PathophysiologySquamouscellcarcinomaisamalignanttumorofepidermalkeratinocytes.Somecasesofsquamouscellcarcinomaoccurdenovo(ie,intheabsenceofaprecursorlesion);however,somesquamou
7、scellcarcinomasarisefromsun-inducedprecancerouslesionsknownasactinickeratoses (AKs).PatientswithmultipleAKsareatincreasedriskfordevelopingsquamouscellcarcinoma.9Squamouscellcarcinomaiscapableoflocallyinfiltrativegrowth,spreadtoregionallymphnodes,anddistantmetastasis,mostoftentothelu
8、ngs.FrequencyUnited
