A Clinico-Pathological Study of Squamous Cell Carcinoma / 대한피부과학회지

ABSTRACT

BACKGROUND: Squamous cell carcinoma(SCC) may occur anywhere on the skin and on mucous membranes with squamous epithelium. OBJECTIVE: The purpose of this study was to investigate the clinico-pathological characteristics of SCC. METHODS: A total of 62 patients with SCC were enrolled in this study. Six cases with metastatic SCC were included. The hospital charts and histopathological slides of the patients with SCC diagnosed at Asan Medical Center from 1989 to 1999 were reviewed. RESULTS: 1. The male and female ratio was 1.81. The mean age at diagnosis was 61.5 years in male patients and 71.8 years in female patients. 2. Most commonly involved sites were the face(41.8%). Upper extremities, trunk, lower extremities, genitalia and scalp were followed in decreasing order. The proximal nail fold was involved in 3 case of primary cutaneous SCC and 1 cases of metastatic SCC. 3. Six cases(9.7%) of metastatic SCC were included. Lung cancer(83.3%) was the most common cause of metastatic SCC in this study. Interestingly, one case presented with SCC of the proximal nail fold revealed metastatic SCC from the lung. 4. The possible causative diseases of primary cutaneous SCC were actinic keratosis(12.5%), burn scar(8.9%), immune suppression(8.9%) owing to kidney transplantation and chemotherapy, arsenical keratosis(7.1%), Bowen's disease(5.4%), trauma(5.4%), osteomyelitis(3.6%), and porokeratosis(1.8%). The causes of 25 cases(44.6%) were undetermined. 5. Histopathological differentiation of the primary cutaneous SCC was performed as follows 29 cases(51.8%) of well-differentiated, 11 cases(19.6%) of moderately-differentiated, 8 cases(14.3%) of poorly-differentiated, 6 cases(10.7%) of acantholytic, and 2 cases(3.6%) of verrucous SCC. 6. Metastatic rate of primary cutaneous SCC was 16.1%. Metastasis of SCC from osteomyelitis (100%) and burn scar(40%) or trauma(33.3%) and that of poorly differentiated SCC(37.5%) were more common. Regional lymph nodes(55.6%), skin(44.4%), and lung(33.3%) were common metastatic organs.