The sun-exposed head and neck are the most frequent sites for these cancers to arise and in most patients diagnosed with a cutaneous squamous cell carcinoma, local treatment is usually curative.
High-Risk Features of the Primary Tumor
On sensitive/mucosal locations (such as the genitals) as well as areas that tend to have lots of sun exposure, such as the central face, eyelids, eyebrows, on or around the nose, lips, chin, jaw, temple, and ear (the mask area), hands, and feet.
What are the most common places for squamous cell carcinoma to occur? Skin: This is by far the most common location. We see more of these every year than all of the others combined. Head and neck: Squamous cell carcinomas of the head and neck include cancers of the mouth, throat and voice box.
The risk of cSCC metastasis is low and has been cited to range between 35 and 9% [6]. When metastasis does occur, the vast majority of metastases are found in the parotid or cervical lymph nodes.
Squamous cell carcinoma of the skin most often occurs on sun-exposed skin, such as your scalp, the backs of your hands, your ears or your lips. But it can occur anywhere on your body, including inside your mouth, the bottoms of your feet and on your genitals.
Lymphatic spread is the most common route of initial metastasis for carcinomas.
Metastatic squamous neck cancer with occult primary is a disease in which squamous cell cancer spreads to lymph nodes in the neck and it is not known where the cancer first formed in the body. Signs and symptoms of metastatic squamous neck cancer with occult primary include a lump or pain in the neck or throat.
About 40% of intraoral squamous cell carcinomas begin on the floor of the mouth or on the lateral and ventral surfaces of the tongue. About 38% of all oral squamous cell carcinomas occur on the lower lip; these are usually solar-related cancers on the external surface.
In general, the squamous cell carcinoma survival rate is very high—when detected early, the five-year survival rate is 99 percent. Even if squamous cell carcinoma has spread to nearby lymph nodes, the cancer may be effectively treated through a combination of surgery and radiation treatment.
Squamous cell carcinoma of the head and neck occurs in the outermost surface of the skin or certain tissues within the head and neck region including the throat, mouth, sinuses and nose. Squamous cell carcinoma makes up about 90 percent of all head and neck cancers.
Squamous cell and basal cell carcinoma occur more often in people who have more exposure to the sun or other sources of UV radiation over their lifetime. Previous skin cancer. People who have had any form of skin cancer have a higher risk of developing another skin cancer.
What is aggressive squamous cell carcinoma? “Aggressive SCC” or “high-risk SCC” is cancer that is more likely to recur (return after initial treatment) or metastasize (spread to other parts of the body).
Although squamous cell carcinoma can be more aggressive than basal cell cancer, the risk of this type of cancer spreading is low—as long as the cancer is treated early, Dr. Leffell says.
Basal and squamous cell cancers don't often spread to other parts of the body. But if your doctor thinks your skin cancer might spread, you might need imaging tests, such as MRI or CT scans.
Dr. Hanke: The first place SCCs metastasize to is the regional lymph nodes. So if you have a squamous cell carcinoma on your cheek, for example, it would metastasize to the nodes in the neck.
What are the most common sites of metastatic cancer? The most common sites for cancers to metastasize include the lungs, liver, bones and brain. Other places include the adrenal gland, lymph nodes, skin and other organs. Sometimes, a metastasis will be found without a known primary cancer (point of origin).
Metinel Node—The First Lymph Node Draining a Metastasis—Contains Tumor-Reactive Lymphocytes.
moving through the walls of nearby lymph nodes or blood vessels. traveling through the lymphatic system and bloodstream to other parts of the body. stopping in small blood vessels at a distant location, invading the blood vessel walls, and moving into the surrounding tissue.
When caught promptly, almost all squamous cell carcinomas (SCCs) of the skin can be successfully treated. But when they become more advanced, these skin cancers can become dangerous. That's why it's important to be on the lookout for any SCC warning signs, including new, changing or unusual skin growths.
Research exploring cSCC metastasis found an overall rate of 1.2–5% but this range varies, and some dermatologists are finding cSCC's ability to spread more worrisome. This allows for clinical variation in the appropriate treatments and follow-up guidelines when diagnosing a patient with cSCC.
Stage 4 squamous cell carcinoma
In stage 4, the cancer can be any size and has spread (metastasized) to one or more lymph nodes which are larger than 3 cm and may have spread to bones or other organs in the body.
Patients with stage I, II, or III cancer have the best survival, whereas patients with stage IV or recurrent cancer who are older than 66.5 years have the worst survival. Patients with stage IV or recurrent cancer who are younger than 66.5 years have intermediate survival.
Treatment should happen as soon as possible after diagnosis, since more advanced SCCs of the skin are more difficult to treat and can become dangerous, spreading to local lymph nodes, distant tissues and organs.