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    A squamous cell carcinoma that disproportionately affects men

    Factors that drive lip squamous cell carcinomas in men.



    Secondary malignancies

    Patients who have had a hematopoietic stem cell transplant (HSCT) have a 2-6 percent higher risk of developing a secondary malignancy 10 years post treatment, and a 6-13 percent increase at 15 years. Adding male gender and a post-transplant chronic graft versus host disease (GvHD) to the mix heightens the risk, Dr. Kibbi said. Typically, leukemia or lymphoma is the most common secondary malignancy followed by SCC of oral cavity, skin or GI track. The risk for oSCC is 17 times greater than that of the average population.

    Last month, during the American Society for Dermatologic Surgery annual meeting in Chicago, Dr. Kibbi presented a case study of 31-yearold man with lSCC who was successfully treated with Mohs micrographic surgery (MMS).

    “SCC of lip can be a challenging diagnosis in the setting of complex medical history,” she said.

    Case study:  31-year-old man

    This was a 31-year-old man with a history of lymphoblastic lymphoma. He was treated with a HSCT, which was complicated by a chronic graft versus host disease. “Three years after the transplant, he developed a verrucous, sessile plaque on the right lower lateral vermilion lip of 2.5 x 1.7 cm extending from the vermilion border to the wet vermilion sparing the vestibule and other oral structures. He had no associated lymphadenopathy,” Dr. Kibbi stated in her presentation.

    “The biopsy findings included atypical parakeratosis above acanthosis composed of atypical eratinocytes with a pushing border into the lamina propria; p16 immunohistochemistry was negative. The lesion was staged T2a by Brigham and Women’s criteria,” she stated.



    NEXT:  Treatment options



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