Squamous cell carcinoma and basal cell carcinoma are the two most common types of non-melanoma skin cancer. Squamous cell carcinoma occurs more often in sun-exposed areas and affects men more than women. Larger lesions, deeper invasion and higher grades are associated with greater recurrence risk. Treatment options include excision, cryotherapy and radiation therapy. Basal cell carcinoma is more common and occurs predominantly in light-skinned individuals on sun-exposed areas. The nodular type is most common. Treatment involves wide local excision, Mohs surgery, or radiation therapy depending on size and location.
Squamous cell carcinoma of skin | management -all medical aspects.martinshaji
Squamous cell carcinoma of the skin is a common form of skin cancer that develops in the squamous cells that make up the middle and outer layers of the skin. Squamous cell carcinoma of the skin is usually not life-threatening, though it can be aggressive. Squamous cell carcinomas may appear as flat reddish or brownish patches in the skin, often with a rough, scaly, or crusted surface. They tend to grow slowly and usually occur on sun-exposed areas of the body, such as the face, ears, neck, lips, and backs of the hands.
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Squamous cell carcinoma of skin | management -all medical aspects.martinshaji
Squamous cell carcinoma of the skin is a common form of skin cancer that develops in the squamous cells that make up the middle and outer layers of the skin. Squamous cell carcinoma of the skin is usually not life-threatening, though it can be aggressive. Squamous cell carcinomas may appear as flat reddish or brownish patches in the skin, often with a rough, scaly, or crusted surface. They tend to grow slowly and usually occur on sun-exposed areas of the body, such as the face, ears, neck, lips, and backs of the hands.
this is a detailed discussion on the topic
please comment
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Each year, millions of people find out that they have skin cancer. Skin cancer is almost 100% curable if found early and treated right away. It is possible to prevent some types of skin cancer. Basal cell carcinoma and squamous cell carcinoma are sometimes called non-melanoma skin cancer.
Basal Cell Carcinoma (BCC)
BCC is the most common cancer in humans.
Caused by UVR; PTCH gene mutation in most cases.
Clinically different types: nodular, ulcerating, pigmented, sclerosing , and superficial.
BCC is locally invasive, aggressive, and destructive but slow growing, and there is very limited (literally no) tendency to metastasize.
Skin Lesions: There are five clinical types:
1- Nodular
2- Ulcerating
3- Sclerosing (Cicatricial),
4- Superficial,
5- Pigmented.
Melanoma, the most serious type of skin cancer.
This presentation presents the skin cancer, basal cell carcinoma, Squamous cell carcinoma, and its symptoms, treatment, case
Each year, millions of people find out that they have skin cancer. Skin cancer is almost 100% curable if found early and treated right away. It is possible to prevent some types of skin cancer. Basal cell carcinoma and squamous cell carcinoma are sometimes called non-melanoma skin cancer.
Basal Cell Carcinoma (BCC)
BCC is the most common cancer in humans.
Caused by UVR; PTCH gene mutation in most cases.
Clinically different types: nodular, ulcerating, pigmented, sclerosing , and superficial.
BCC is locally invasive, aggressive, and destructive but slow growing, and there is very limited (literally no) tendency to metastasize.
Skin Lesions: There are five clinical types:
1- Nodular
2- Ulcerating
3- Sclerosing (Cicatricial),
4- Superficial,
5- Pigmented.
Melanoma, the most serious type of skin cancer.
This presentation presents the skin cancer, basal cell carcinoma, Squamous cell carcinoma, and its symptoms, treatment, case
Suboccipital lymphadenectomy for patients with occipital squamous cell carcin...Dr./ Ihab Samy
F. Fouad Saleep(1), I. Fayek(1), I. Farahat(2)
(1)National Cancer Institute - Cairo University, Surgical Oncology Department, Cairo, Egypt.
(2)National Cancer Institute - Cairo University, Pathology Department, Cairo, Egypt.
Poster presentation No.3224 at the 17th European Cancer Organization conference ECCO 17, Amsterdam-Netherlands, September 2013.
Cancer begins in cells, the building blocks that make up tissues. Tissues make up the kidneys and the other organs of the body.
Normal cells grow and divide to form new cells as the body needs them. When normal cells grow old or get damaged, they die, and new cells take their place.
Sometimes, this process goes wrong. New cells form when the body doesn’t need them, and old or damaged cells don’t die as they should. The buildup of extra cells often forms a mass of tissue called a growth or tumor.
Tumors in the kidney can be benign (not cancer) or malignant (cancer). Benign tumors are not as harmful as malignant tumors:
Benign tumors (such as cysts):
-- are usually not a threat to life
-- can be treated or removed and usually don’t grow back
-- don’t invade the tissues around them
-- don’t spread to other parts of the body
Malignant growths:
-- may be a threat to life
-- usually can be removed but can grow back
-- can invade and damage nearby tissues and organs
-- can spread to other parts of the body
Kidney cancer cells can spread by breaking away from the kidney tumor. They can travel through lymph vessels to nearby lymph nodes. They can also spread through blood vessels to the lungs, bones, or liver. After spreading, kidney cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues.
National Cancer Institute:
#Skin malignancy is the most common malignancy in fair-skinned populations.
#Skin malignancies are either non-melanoma or melanoma.
#A persistent skin lesion that does not heal is highly suspicious for malignancy and should be examined by a health care provider.
# Early detection and treatment can often lead to a highly favourable prognosis.
Includes most common tumors of oral cavity including scc,bcc, melanoma, ameloblastoma, odontoma, fibromas, pindborg tumors etc.
Presented by Dr. Binaya Subedi
Gastrointestinal Stromal Tumors: A clinicopathologic study of 67 cases.Dr./ Ihab Samy
Amr H. Sleema MD; Ihab S. Fayeka MD; Hany F. Habashyb MD;Amany Saberc MD;Alfred E. Namourd MD;Nevine F. Habashye MD
a: Surgical Oncology Department – National Cancer Institute – Cairo University – Egypt.
b: Surgery Department – Fayoum teaching hospital – Fayoum University – Egypt.
c: Medical Oncology Department – Minia Cancer Center – Egypt.
d: Medical Oncology Department – National Cancer Institute – Cairo University – Egypt.
e: Surgical Pathology Department - National Cancer Institute – Cairo University – Egypt.
Kasr el-aini journal of surgery Volume 15, No.2, May 2014
F. Fouad Saleep(1), I. Fayek(1), I. Farahat(2)
(1)National Cancer Institute - Cairo University, Surgical Oncology Department, Cairo, Egypt.
(2)National Cancer Institute - Cairo University, Pathology Department, Cairo, Egypt.
Poster presentation No.3224 at the 17th European Cancer Organization conference ECCO 17, Amsterdam-Netherlands, September 2013
Impact of dead space closure and lymph vessel ligation during MRM on Post-ope...Dr./ Ihab Samy
Hany F. Habashy MD.a , Ihab S. Fayek MD b , Mohamed I.Abd el aziz MD a
a:Department of Surgery-Fayoum University Hospital-El Fayoum , Egypt.
b:Department of Surgical Oncology –National Cancer Institute – Cairo University ,Egypt.
Kasr el-aini journal of surgery Volume 14, No.2, May 2013
Poster Presentation at the 6th Breast-Gynecological international cancer conference (BGICC) at Fairmont Towers Hotel, Cairo-Egypt on the 9th-10th of January 2014
Sentinel lymph node biopsy before neoadjuvant chemotherapy for clinical axill...Dr./ Ihab Samy
Ihab S. Fayeka MD; Fouad A. Saleepa MD; Hany F. Habashyb MD; Alfred E. Namourc MD ; Iman G. Farahatd MD ;Magdy Kotbe MD
a: department of surgical oncology - national cancer institute - Cairo university - Egypt.
b: department of surgery - Fayoum university hospital - El Fayoum - Egypt.
c: department of medical oncology - national cancer institute - Cairo university - Egypt.
d: department of surgical pathology - national cancer institute - Cairo university - Egypt.
e: department of nuclear medicine - national cancer institute - Cairo university - Egypt.
For correspondance contact: drihab74@hotmail.com
Kasr el-aini journal of surgery Volume 14, No.1, January 2013
Treatment and early outcome of 11 children with hepatoblastoma.Dr./ Ihab Samy
Fouad A. Fouad saleep MD., Ihab samy Fayek MD.
Department of Surgical Oncology – National Cancer Institute – Cairo University - Egypt.
Kasr el-aini medical journal Volume 18, No.4, October 2012.
Cancer of Oral Cavity Abutting the Mandible; Predictors of Loco-regional Fail...Dr./ Ihab Samy
TAREK K. SABER, M.D.; HESHAM A. HUSSEIN, M.D.; ALI H. MEBEED, M.D.;
HESHAM I. EL SEBAI, M.D.; IHAB SAMI, M.D. and IMAN G. FARAHAT, M.D.*
The Departments of Surgical Oncology and Pathology*, National Cancer Institute, Cairo University.
Journal of the Egyptian Nat. Cancer Inst., Vol. 21, No. 3, September: 219-227, 2009
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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3. Epidemiology
• The second most common skin cancer, ranking
behind basal cell carcinoma (4:1).
• 20% of cutaneous malignancies.
• Generally occurs in mid to late life (usually
after age 40).
• Most commonly affects areas of sun exposure.
• Men are affected more often than women.
4. • A number of variables must be considered
when evaluating a squamous cell carcinoma.
• They relate to the lesion’s ability to recur
locally and to metastasize:
1. Location.
2. Size.
3. Depth of invasion.
4. Histologic grade.
5. Location
• The central zone of the face is considered a high
risk area for subclinical extension because of its
anatomy; lesions located in this area are
therefore at high risk for local recurrence.
• Lesions of the temple, dorsum of the hand, lips,
scalp, and penis are associated with a high risk of
metastatic disease. Patients with lesions in these
areas must be carefully examined for evidence of
regional lymphadenopathy.
6. Size
• The larger the lesion, the greater the chance
for local recurrence. As a consequence,
excision margins are selected according to
tumor size.
• A 4- to 5-mm margin for lesions <2cm in
diameter and a 6- to 9-mm margin for lesions
>2cm in diameter have been recommended.
7. Depth of invasion and histologic grade
• Invasion into the deep dermis or subcutaneous
tissue and a Broder’s grade 2 or higher are
associated with higher recurrence rates.
• Squamous cell cancers demonstrate a propensity
to invade along perineural planes.
• The immunosuppressed or immunocompromised
patient has an increased risk for local recurrence
or metastasis (typically to regional lymph nodes).
8. Verrucous squamous cell cancer
• An exophytic wart-like appearance.
• Often arises on the foot or glans penis and
anal canal (giant condyloma of Buschke-
Lowenstein).
• Histologically, there is no invasion of the
dermis.
9. • Squamous cell carcinomas are generally divided into
spindle cell and acantholytic types.
• Spindle cell tumors may appear similar to malignant
melanoma or superficial malignant fibrocytomas.
• Immunohistologic staining can help make this
differentiation. Squamous cell cancers are positive for
cytokeratin and negative for S-100; melanomas are S-
100-positive and cytokeratin-negative.
• Acantholytic-type squamous cell cancers usually arise
from acantholytic solar keratoses.
10. Risk Factors
• Cumulative lifetime exposure to sunlight
Ultraviolet B radiation (290–320mm).
• Whites more than Blacks.
• Scrotal tumors in chimney sweeps (soot is the
causative agent).
• Chronic arsenic exposure.
• Exposure to radiation.
• Compromised immunity.
11. • Human papilloma virus (HPV) exposure (16 and
18).
• Thermal injury.
• Chronic ulceration.
• Sinus tracts.
• Hidradenitis suppurativa.
• Chronic cutaneous lupus erythematosus.
• Genetic predisposition (xeroderma pigmentosum,
epidermal dysplasia, and recessive dystrophic
epidermolysis bullosa and oculocutaneous
albinism).
• Alcohol and tobacco use.
13. Excision
• Wide excision: 4–5 mm margins for lesions <2cm in diameter and
6–9mm for larger lesions.
• Tumors at high risk for local recurrence and metastases are those
>1–2cm in diameter that have invaded the mid-dermis or deeper.
• Those involving cartilage and bone are extremely high risk.
• Squamous cell carcinoma of the lip, ear, temple, and genitalia and
lesions associated with the preexisting conditions previously
discussed are also high risk.
• For these high risk lesions, excision with a frozen section margin
check should be used to assess the adequacy of excision.
14. Superficial ablative techniques
• Squamous cell carcinoma in situ (Bowen’s
disease).
• Lesions that invade no deeper than the
superficial dermis.
N.B. Tumors that are indurated and have
undermined the skin laterally and those with
associated local pain may be deeply invasive and
should be treated by excision.
15. 1-Curettage and electrodesiccation
• Superficial squamous cell cancers.
• Should not be used for lesions with aggressive
histology, large size, or high risk anatomic
location (central face).
• First, curettage is performed by paring down
the lesion to normal tissue.
• Then electrodesiccation is used to destroy
potential tumor nests at the base.
16.
17.
18. 2-Cryotherapy
• Freezes tissue to -195.5°C with liquid nitrogen.
• Can be used for small lesions (<2cm) on the
eyelid, ear, chest, back, or tip of the nose.
• Also used for recurrent tumors with definable
margins.
• Should not be used for eyelid free margins,
the vermilion border of the lip, ala nasi, scalp,
and tumors >3cm.
19.
20. Radiation therapy
• Cure rates approach 92%.
• Of particular value in the central face, ear, and forehead,
where excisional therapy is potentially deforming.
• Has the advantage of treating a wide region around the
tumor with excellent local control and good cosmetic
outcome.
• Prior to initiating therapy, a biopsy should be obtained for
both histologic confirmation and evaluation of tumor
thickness.
21. • Most tumors are treated with a dose of 4000–6000 cGy
to the superficial skin.
• The dose is usually divided over 3–4 weeks to prevent
complications.
• Short term, the most troublesome sequelae after
irradiation is “burn” to the area.
• Long-term sequelae include destruction of hair follicles
and sweat glands, radiation dermatitis leading to
changes in skin pigmentation (hyper- or
hypopigmentation), and the development of radiation-
induced precancerous lesions.
23. • A malignancy of basaloid epithelial cells and is
the most common cancer, outnumbering
cutaneous squamous cell cancer 4 : 1.
• Most often affects light-skinned people, and
rarely affects those with dark skin.
• Develops mainly on sun-exposed areas, the
incidence varying directly with increasing
accumulated sun exposure and inversely with
increasing skin pigmentation.
24.
25. Histology
• Several distinctive clinical subtypes that correlate
with histology and biologic potential.
• In addition, these subtypes affect treatment
choices.
• Histologic subtypes include:
1. Nodular basal cell cancer (most common)
2. Morpheaform.
3. Superficial.
4. Fibroepitheliomatous.
5. Infundibulocystic.
26.
27. Nodular basal cell cancer
• An elevated papule with overlying telangiectasia.
• It can become ulcerated as it enlarges, giving the
appearance of having been nibbled at, leading to its
name “rodent ulcer.”
• Pigmented basal cell cancer is a variant of nodular
basal cell cancer that, because of its dark pigment,
must be differentiated from melanoma.
• This type often occurs in dark-skinned individuals.
28.
29. Morpheaform or sclerosing basal cell cancers
• Also known as fibrosing or desmoplastic.
• A flat, scar-like appearance.
• Some demonstrate endophytic growth leading to a
true tumor margin that is larger than the visible margin
(should be palpated carefully to assess the true extent
of tissue induration).
• This biologic feature leads to a higher recurrence rate
and makes it considered aggressive.
30.
31.
32. Superficial basal cell cancers
• Tend to appear on the trunk and extremities.
• They appear as erythematous patches, some
have an overlying patchy scale-like or
pigmented appearance.
• They are the most common type of basal cell
cancer, seen with chronic arsenism and in
radiation fields.
35. Surgical excision
• The margin of excision for basal cell cancers
<1cm in diameter should be 4–5mm wide.
• The margin should be increased up to 9 mm
for aggressive growth pattern basal cell cancer
and those >1cm in diameter.
• Margin checks at the time of excision are
mandatory for optimizing results.
36. Mohs’ micrographic surgery (MMS)
• Described in 1941 by Frederick Mohs.
• Its main advantages are high cure rates and
minimal tissue loss.
• Its ability to optimize tissue preservation is
important in areas where maintaining
function and cosmetic appearance is difficult,
such as the nose, eyelids, lips, ears, digits, and
genitalia.
37.
38. Irradiation
• Cure rates of 96% and a favorable cosmetic outcome
for small lesions of the central face including the
eyelids, nose, and lips.
• Radiation dose varies between 100 and 300kV per day
and is given according to several fractionation
schedules.
• Typically, 15–17 fractions are given for tumors <2cm in
diameter, increased to 20–22 fractions for tumors
>2cm in diameter, and increased to 30–33 fractions for
larger lesions involving cartilage.