Frequency of squamous cell carcinoma (SCC) invasion in transected SCC in situ referred for Mohs surgery: the Dartmouth−Hitchcock experience. (27th April 2015)

• Record Type: Journal Article
• Authors: Knackstedt, Thomas J.; Brennick, Jeoffry B.; Perry, Ann E.; Li, Zhongze; Quatrano, Nicola A.; Samie, Faramarz H.
• Is Part Of: International journal of dermatology. Volume 54:Number 7(2015:Jul.)
• Page Start: 830
• Page End: 833
• Publication Date: 2015-04-27
• Subjects: Dermatology -- Periodicals; 616.5
• DOI: 10.1111/ijd.12867
• Languages: English
• ISSNs: 0011-9059

Abstract

<abstract abstract-type="main" id="ijd12867-abs-0001"> <title>Abstract</title> <sec id="ijd12867-sec-0001" sec-type="section"> <title>Background</title> <p>Squamous cell carcinoma (SCC) <italic>in situ</italic> may be transected in a superficial biopsy, which makes it difficult to distinguish between <italic>in situ</italic> and invasive carcinoma. This study investigated the frequency of invasive SCC in transected SCC <italic>in situ</italic> referred for Mohs surgery.</p> </sec> <sec id="ijd12867-sec-0002" sec-type="section"> <title>Methods</title> <p>A retrospective chart review was performed to identify subjects with biopsy‐proven, transected SCC <italic>in situ</italic> referred for Mohs surgery. The incidence of invasion, histologic variables, preoperative and intraoperative correlations, and clinical factors were determined and recorded.</p> </sec> <sec id="ijd12867-sec-0003" sec-type="section"> <title>Results</title> <p>Of 51 cases identified, five (9.8%) were found to harbor invasive SCC, 15 (29.4%) showed SCC <italic>in situ</italic>, and 28 (54.9%) showed evidence of scarring, inflammation, or actinic keratosis at the prior biopsy site. Invasive lesions required significantly more stages of Mohs surgery to obtain tumor clearance but were similar with regard to patient age, symptoms, and family and personal histories of skin cancer. Preoperative lesion size and duration were greater in invasive cases, but these differences did not reach statistical significance.</p> </sec> <sec id="ijd12867-sec-0004" sec-type="section"> <title>Conclusions</title> <p>A small number of transected SCCs <italic>in situ</italic>, to which the caveat "invasion cannot be ruled out" can be applied, have an invasive component that is identified during Mohs surgery. Definitive treatment choices should depend on the physician's impression, the clinical characteristics of the lesion, tumor location, patient comorbidities, and patient desires.</p> </sec> </abstract>