Search

Squamous cell carcinoma (SCC) arising from an epidermal inclusion cyst (EIC) is uncommon. We present a case of a 70-year-old man with a scalp nodule with persistent discharge that was resected based on the clinical impression of an EIC. Histopathologic exam showed an infundibular EIC with an epidermal type of squamous epithelium; however, some of the cyst lining and lumen was replaced by squamous proliferation with malignant features. There are 56 cases of SCC arising in EICs reported in the English literature. Though suspected EICs are commonly benign, a thorough pathologic evaluation is required to rule out malignancy. [ABSTRACT FROM AUTHOR]

Background Perineural invasion ( PNI) is an important histologic finding and may be a negative prognostic factor for squamous cell carcinoma ( SCC). It may be associated with more-aggressive tumor behavior. Mohs surgeons encounter microscopic PNI regularly and must be able to diagnose it accurately to guide care decisions. Objective To describe benign histologic mimickers of PNI and neural structures in SCC commonly encountered on frozen, hematoxylin and eosin-stained sections and to review how to differentiate them from PNI. Methods and Materials Review of the literature regarding histologic mimickers of PNI and additional contributions to frozen section PNI and nerve tissue mimickers. Results We describe benign findings, including arrector pili muscles, eccrine muscles, vessels, granulomatous inflammation, and eddies of SCC, that may each be mistaken for nerves or PNI. We discuss the ways in which they may be distinguished on frozen sections and review other commonly encountered entities that resemble PNI. Conclusion Perineural inflammation and peritumoral fibrosis are common mimickers of PNI on frozen section, although other mimickers exist on permanent sections. Normal structures may appear 'neural' by way of frozen tissue orientation, processing, or inflammation and thus must be differentiated from nerve tissue and PNI during Mohs surgery. [ABSTRACT FROM AUTHOR]

Background: The population of people aged 90 years and older is expected to more than triple by 2050. The incidence of skin cancers is increasing. Objective: We sought to determine whether treatment of patients aged 90 years and older with skin cancer by Mohs micrographic surgery (MMS) changed their survival. Methods: A group of 214 patients aged 90 years and older who underwent MMS from July 1997 to May 2006 was identified. Patient gender, age, tumor type, size, site, defect size, number of MMS stages, and surgical repair were recorded. Comorbid medical conditions were assessed using the Charlson index. Actual survival was compared with expected length of survival using life tables. Data were analyzed by the Kaplan-Meier method with log rank significance tests. Results: Average patient age was 92.3 years. All patients tolerated the procedures well with no deaths within 1 month after surgery. Median survival after surgery was 36.9 months. Tumor characteristics, defect size, number of surgical stages, and closure type did not affect survival. There was no significant difference in survival based on comorbidities according to Charlson scores. Instantaneous mortality hazard was highest 2 to 3 years after surgery. Limitations: Specific causes of death were not accessible. Conclusion: This growing section of the population may safely undergo MMS. [Copyright &y& Elsevier]

BACKGROUND Squamous cell carcinoma in situ (SCCIS) is thought to be a precursor to squamous cell carcinoma. It should be treated before invasive cancer develops, especially in transplant recipients, who may develop more aggressive skin cancers. Treatment can involve surgical and nonsurgical methods. OBJECTIVE To review the evidence available in the English medical literature for different treatment options of SCCIS on nongenital skin and evaluate the efficacy of each option. METHODS AND MATERIALS A Pubmed search of articles describing the treatment of SCCIS was conducted. Keywords were 'treatment,' 'Bowen's disease,' and 'squamous cell carcinoma in situ.' Articles describing the use of surgical excision, curettage and electrodesiccation, cryotherapy, 5-fluorouracil, imiquimod, radiation, photodynamic therapy, lasers, and rarer methods were reviewed. RESULTS No single treatment can be said to be superior for any one situation. Most studies are small, limiting the power of each. Further studies are needed to clarify optimal treatment protocols for nonsurgical methods such as cryotherapy, photodynamic therapy, and topical chemotherapy. CONCLUSION There are many methods available to treat SCCIS. Physicians should consider each patient's situation while keeping in mind that treatment protocols have not been fully defined for most options. The authors have indicated no significant interest with commercial supporters. [ABSTRACT FROM AUTHOR]

The article presents a case study of 12 patients aging 44 to 83 years who were presented for Mohs micrographic surgery due to basal and squamous cell carcinoma. The surgery that was conducted to the patients used full-thickness skin grafts (FTSGs) secured with 2-octylcyanocrylate and adhesive strips. The study shows the advantages of using 2-octylcyanoacrylate in Mohs micrographic surgery.