Aggressive Cutaneous Squamous Cell Carcinoma of the Head and Neck: A Review

Desai, Neha; Divatia, Mukul K.; Wagh, Aditya

doi:10.3390/curroncol30070487

Cited by 7 publications

(5 citation statements)

References 95 publications

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“…Cutaneous squamous cell carcinoma (cSCC) is the second most common malignancy in humans, after basal cell carcinoma, presenting with an annual incidence of 1.8 million in the US ( 1 , 2 ). The reported metastatic and mortality rate of cSCC varies at 2%–5% and 1%–2%, respectively ( 1 – 3 ).…”

Section: Discussionmentioning

confidence: 99%

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Case Report: Dostarlimab for treatment of aggressive cutaneous squamous cell carcinoma

Gandarillas,

Tang,

Dasgeb

2024

Front. Med.

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Cutaneous squamous cell carcinoma (cSCC) is the second most common malignancy with the aggressive cSCC subtype being especially worrisome due to its higher metastatic and mortality rate. An 80-year-old immunocompetent Caucasian man presented with a locally advanced and recurrent cSCC for which he underwent six Mohs surgeries, radiation therapy, and standard immunotherapy treatments. Throughout treatment, the patient’s cancer continued to progress across different regions of the face. Biopsy and analysis were performed and showed that the cSCCs had a high mutational burden and oncogenes known to be present in tumors with aggressive nature. After the algorithmically applied standard of care failed to cure or control the progressing disease, the genetic analysis favored dostarlimab as a suitable option. With only three doses of 500 mg dostarlimab q3 weeks, the patient showed a fast response with macroscopic resolution of clinically discernible disease of, the previously noted, locally advanced cSCC on his right forehead, as well as other primary keratinocyte carcinomas on his left contralateral face, nose, left leg, and neck. This remarkable case can present an option for complex patients with locally advanced and recurrent cSCC who failed the current standard of care. Moreover, it warrants a proper clinical trial to assess efficacy and potential indication of dostarlimab in such patients. Of note is the presence of a KMT2D mutation and its well-identified correlation with mismatch repair deficiency (dMMR) and poor prognosis, which can play an informative role in clinical decision making and precision therapeutic choice at the point of care.

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Section: Discussionmentioning

confidence: 99%

“…Clinically, aggressive cSCC tumors are ulcerated, >2 cm, and often occur on the sun damaged skin of the head and neck of elderly Caucasian men. These tumors have a higher risk for metastasis, unfavorable response to standard treatments, and eventually end in mortality ( 2 , 3 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Dostarlimab for treatment of aggressive cutaneous squamous cell carcinoma

Gandarillas,

Tang,

Dasgeb

2024

Front. Med.

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“…Factors that predispose patients to develop cSCC include light skin, exposure to sunlight, ultraviolet radiation, immunosuppression, human papillomavirus, chronic conditions that lead to scarring, genetic syndromes, and certain environmental exposures [ 4 ]. The main high-risk prognostic markers for cSCC include the tumor size, site, history of radiotherapy, immunosuppression, and perineural invasion [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Rapidly Growing Giant Squamous Cell Carcinoma of the Head: A Case Report

Leal,

Hobbs,

Gill

et al. 2024

Cureus

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Giant squamous cell carcinoma (GSCC) of the skin arising on the head presents a distinctive clinical challenge due to its rarity, aggressive behavior, and potential for disfigurement. A male in his 70s with a history of tobacco cigarette use presented to the emergency department with a painful, bleeding mass on the right parietal scalp. On admission, a brain CT revealed a fungating mass with no cortical breakthrough or osseous erosion, measuring 7.9 x 5.7 x 2.5 cm. An ultrasound-guided tissue biopsy was performed and revealed poorly differentiated squamous cell carcinoma. The patient was discharged home with instructions from oncology to continue with outpatient treatment. At this time, the prognosis is good if treatment is received.

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“…Another relevant histological variable is perineural invasion. Perineural invasion predicts a poor prognosis in several cancers such as pancreatic [ 37 ], gastric [ 38 ], and head and neck CSCC [ 39 ]. In the present study, it was found that patients with tumors presenting perineural invasion had a significantly higher risk of disease progression.…”

Section: Discussionmentioning

confidence: 99%

VEGFC Gene Expression Is Associated with Tumor Progression and Disease-Free Survival in Cutaneous Squamous Cell Carcinoma

García-Pérez,

Melgar-Vilaplana,

Sifaoui

et al. 2023

IJMS

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Cutaneous squamous cell carcinoma (CSCC) is one of the most common cancers in the skin. CSCC belongs to the non-melanoma skin cancers, and its incidence is increasing every year around the world. The principal routes of tumor progression are related to angiogenesis and lymphangiogenesis. In this study, we assess the gene expression of the relevant biomarkers of both routes in 49 formalin-fixed paraffin-embedded (FFPE) CSCC samples in an attempt to determine a molecular profile that correlates with the tumor progression and disease-free survival (DFS). The results were enhanced by a posttranscriptional analysis using an immunofluorescence assay. Overexpression of the vascular endothelial growth factor C (VEGFC) gene was found in patients with tumor progression (p = 0.022) and in patients with perineural invasion (p = 0.030). An increased expression of protein VEGFC in samples with tumor progression supported these results (p = 0.050). In addition, DFS curves showed differences (p = 0.027) for tumors with absent-low VEGFC expression versus those with high levels of VEGFC expression. No significant influence on DFS was detected for the remaining analyzed genes. VEGFC expression was found to be a risk factor in the disease progression (HR = 2.675; 95% CI: 1.089–6.570; p = 0.032). Our main results suggest that VEGFC gene expression is closely related to tumor progression, DFS, and the presence of perineural invasion.

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Aggressive Cutaneous Squamous Cell Carcinoma of the Head and Neck: A Review

Cited by 7 publications

References 95 publications

Case Report: Dostarlimab for treatment of aggressive cutaneous squamous cell carcinoma

Case Report: Dostarlimab for treatment of aggressive cutaneous squamous cell carcinoma

Rapidly Growing Giant Squamous Cell Carcinoma of the Head: A Case Report

VEGFC Gene Expression Is Associated with Tumor Progression and Disease-Free Survival in Cutaneous Squamous Cell Carcinoma

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