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Squamous cell carcinoma presenting as subcutaneous nodules.

N R Howe¹, P G Lang

¹Department of Dermatology, Medical University of South Carolina, Charleston 29425.

The Journal of Dermatologic Surgery and Oncology

|October 11, 1991

Summary

Subcutaneous squamous cell carcinomas (SCCs) on the head can be challenging to diagnose. Further examination revealed epidermal connections in most cases, aiding diagnosis.

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Area of Science:

Dermatology
Oncology
Surgical Pathology

Background:

Squamous cell carcinoma (SCC) is a common skin cancer.
Subcutaneous nodules on the head can present diagnostic challenges.
Mohs micrographic surgery is a specialized technique for skin cancer removal.

Observation:

Four patients presented with SCCs as subcutaneous nodules on the head.
Initial histological examination showed no apparent connection to the epidermis.
This raised suspicion of metastasis from an occult primary SCC.

Findings:

Extensive searches for occult primary SCCs were negative.
Subsequent step sectioning of the tumors revealed narrow epidermal connections in three of the four cases.
This suggests that these subcutaneous nodules were indeed primary SCCs with unusual presentation.

Implications:

The findings highlight the importance of thorough histological examination, including step sectioning, for diagnosing subcutaneous SCCs.
This can help differentiate primary SCCs from metastases, guiding appropriate treatment.
Understanding these presentations is crucial for dermatologists and surgeons managing skin cancer.

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