Background: Cutaneous squamous cell carcinoma (C-SCC) is the
second most frequent cutaneous malignancy worldwide and represents a
potentially life-threatening condition due to its ability to demonstrate rapid
progression, aggressive local invasion, and metastatic spread. Although it is
often regarded as relatively indolent, delayed recognition and treatment may
result in advanced disease associated with substantial morbidity and mortality.
This case series highlights five clinically diverse and often misleading
presentations of C-SCC that mimicked benign dermatological conditions, thereby
concealing their malignant potential. Emphasis is placed on the urgency of
early clinical suspicion, prompt histopathological confirmation, and timely
therapeutic intervention, as these measures play a decisive role in modifying
disease course, reducing metastatic risk, and improving overall patient
outcomes.
Objectives: This study highlights the clinical heterogeneity
of C-SCC through diverse presentations, emphasising the need for diagnostic
vigilance.
Methods: A case series of five patients with
histopathologically confirmed C-SCC was analysed. Each case was evaluated for
site, predisposing factors, morphology, and management outcomes. Case 1
involved a Post-burn scar ulcer (Marjolin’s ulcer) treated with excision and
grafting, whereas Case 2 presented as a Groin and penile ulcer with nodal metastasis;
the patient succumbed during chemotherapy. Case 3 was a Keratoacanthoma with
adjacent SCC on the leg, managed with retinoids. Case 4 had an Inguinal lesion
post-hair-plucking trauma; well-differentiated SCC. Case 5 involved Verrucous
carcinoma over condyloma acuminata; partial penectomy performed.
Results: These five cases illustrate the diverse
presentations and histopathological variants of Cutaneous SCC. Lesions arose in
varied contexts—over scars, traumatic or infectious sites, and pre-existing
dermatoses.
Conclusion: This case series highlights the broad and
deceptive clinical spectrum of cutaneous squamous cell carcinoma, ranging from
chronic non-healing ulcers to aggressive keratinising tumours that are
frequently misinterpreted as benign conditions. Importantly, even complicated
and advanced presentations of C-SCC demonstrate significant potential for
improved outcomes when early intervention is undertaken under histopathological
guidance. Timely diagnosis and appropriate management remain critical in
offering the best chance for curative outcomes, minimising the risk of
metastasis, and enhancing overall prognosis.
Recommendations: Clinicians should maintain a high index of
suspicion for non-healing, indurated, or atypical cutaneous lesions.
Author(s) Details
Sharmila Patil
Department of Dermatology, Dr. D.Y. Patil Hospital, Navi Mumbai, India.
Fiza Chaudhary
Department of Dermatology, Dr. D.Y. Patil Hospital, Navi Mumbai, India.
Sabhya Sehgal
Department of Dermatology, Dr. D.Y. Patil Hospital, Navi Mumbai, India.
Aishwarya Patil
Department of Dermatology, Dr. D.Y. Patil Hospital, Navi Mumbai, India.
Amishi Rathod
Department of Dermatology, Dr. D.Y. Patil Hospital, Navi Mumbai, India.
Please see the book here :- https://doi.org/10.9734/bpi/msup/v3/6746
