Four hundred seventeen squamous cell cancers in a heart transplant patient

Squamous cell carcinoma (SCC) is the most common malignancy in organ transplant recipients. In this patient population it pursues a much more aggressive course than in the general population: it occurs with higher frequency and displays a greater tendency to recur locally and metastasize, even after surgical excision. Hence, prophylactic measures assume a very important role in these patients. Patients should minimize their sun exposure and have their skin examined routinely. For those with large numbers of SCCs, systemic retinoids and reduction in immunosuppressive regimen may be of benefit. We present the case of a 70-year-old male heart transplant recipient who developed 334 SCCs, 83 SCCs in situ, and innumerable actinic keratoses during the course of 19 years posttransplant. His cancerous lesions were all excised surgically, but over the years, his cancer assumed a progressively more aggressive course. His immunosuppressive regimen was eventually reduced.