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Development of Compendium for Esophageal Squamous Cell Carcinoma
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Periorbital desmoplastic squamous cell carcinoma.

Verona E Botha1, Kent T K Chow1, Paul J M Salmon2

  • 1a Department of Ophthalmology , Waikato Hospital , Hamilton , New Zealand.

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Summary

Desmoplastic squamous cell carcinoma (SCC) is a rare but aggressive cancer. In the periorbital region, it poses a significant risk of local recurrence and can be sight- and life-threatening.

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Area of Science:

  • Oncology
  • Dermatology
  • Ophthalmology

Background:

  • Desmoplasia, the formation of a dense collagenous stroma around a neoplasm, is associated with various malignancies.
  • Cutaneous squamous cell carcinoma (SCC) can exhibit desmoplasia, which is an independent risk factor for recurrence and metastasis.
  • The periorbital region presents unique challenges for managing aggressive skin cancers due to proximity to vital structures.

Observation:

  • A case series identified seven patients with desmoplastic SCC in the periorbital region.
  • The median age of affected patients was 68 years, with a male predominance (4 out of 7).
  • Mean follow-up was 48 months.

Findings:

  • 29% of patients (2 out of 7) experienced aggressive local recurrence.
  • One patient required extensive salvage surgery, including orbital exenteration, parotidectomy, and neck dissection.
  • Another patient needed repeat excision and adjuvant radiotherapy for recurrent disease.

Implications:

  • Desmoplastic SCC is an uncommon but highly aggressive subtype of cutaneous malignancy.
  • In the periorbital area, this subtype carries a high risk of orbital invasion.
  • Early recognition and aggressive management are crucial due to the potential sight- and life-threatening nature of periorbital desmoplastic SCC.