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    A squamous cell carcinoma that disproportionately affects men

    Factors that drive lip squamous cell carcinomas in men.

     

     

    Treatment options

    Surgery and radiotherapy are standard treatment options for oral squamous cell carcinomas. There were several treatment options: Wide local excision (with 1-2 cm surgical margins), a lymph node dissection with or without radiation and MMS.

    At the recommendation of Dr. Kibbi and her colleagues, Kathleen Suozzi, M.D., and David J. Lef ell, M.D., the patient opted for MMS. Three months after the surgery, he was left with a 5mm keratotic papule on the right lower vermilion. A biopsy revealed it was a hyperplastic actinic keratosis to base. It was treated with electrocautery to the base.

    “This case adds to the sparse literature of five other cases of lip squamous cell carcinoma arising in the setting of GVHD. All six reported cases arose in relatively young males (average age 42). In particular, our patient, only 31 at the time of diagnosis, already had clinical actinic damage and solar elastosis, likely in part due to being on voriconazole prophylaxis, a known potentiator of UV-irradiation-induced damage. Second, all six cases had developed oral GVHD prior to lSCC; by upregulating cytokines (particularly type I interferons), GVHD is thought to enhance malignant transformation,” the authors wrote.

    Mohs micrographic surgery

    Mohs is associated with high cure rates. A prospective, multicenter Australian case series spanning 10 years reviewed 1,263 patients with squamous cell carcinoma who were treated with Mohs micrographic surgery. Researchers found a five-year recurrence rate of 3.9 percent. For recurring tumors, that rate jumped to 5.9 percent compared to 2.6 percent of primary tumor excisions. For patients with perineural invasion, the recurrence rates were 8 percent over five years.

     


    REFERENCES

    Rizzo JD, Curtis RE, Socie G, et al. “Solid cancers after allogeneic hematopoietic cell transplantation,” Blood. 2009. DOI: 10.1182/blood-2008-05-158782

    Bota JP, Lyons AB, Carroll BT. “Squamous Cell Carcinoma of the Lip-A Review of Squamous Cell Carcinogenesis of the Mucosal and Cutaneous Junction,” Dermatologic Surgery. April 2017. DOI:10.1097/DSS.0000000000001020.

     Anastasios K Markopoulos. “Current Aspects on Oral Squamous Cell Carcinoma,The Open Dentistry Journal. Aug. 10, 2012. DOI:10.2174/1874210601206010126

    “Squamous Cell Carcinoma of the Lip in a Patient with Graft-Versus-Host Disease,” Nour Kibbi, M.D., and Kathleen Suozzi, M.D. American Society for Dermatologic Surgery annual meeting, October 2017, Chicago.

    Leibovitch I, Huilgol SC, Selva D, et al. “Cutaneous squamous cell carcinoma treated with Mohs micrographic surgery in Australia I. Experience over 10 years,” JAAD August 2005.

    Vivek V. Gurudutt and Eric M. Genden. "Cutaneous Squamous Cell Carcinoma of the Head and Neck," Journal of Skin Cancer. Feb. 21, 2011. DOI:10.1155/2011/502723

     

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