Abstract Number: 224

Cutaneous SCC with dermal lymphatic spread: whensurgery is not enough

B. Yau , B.S. Daniel , V. Estall , A. Chauhan , A. Webb

Meeting: 2015 Dermcoll

Session Information

Date: -

Session Title: Poster Presentations

Session Time: -

Dermal lymphatic spread is known to be a poor prognostic
indicator of aggressive cutaneous squamous cell carcinoma
With the highest prevalence of skin cancer in the
world, Australia deals with the entire spectrum of disease
and as such, can be presented with management dilemmas
of tumours that demonstrate rare behaviors such as dermal
lymphatic spread. Cutaneous SCC is known to spread via
dermal lymphatics and can manifest as cutaneous in-transit
disease. Currently, there are no “best practice guidelines”
for managing this problem.
There re cases of cutaneous SCC spreading via dermal
lymphatics which do not present with macroscopic nodules
indicating their extent. It can be difficult to attain a clear
margin and therefore they can have a high risk of recurrence
and metastasis. This paper reports a patient with
aggressive cutaneous SCC of the scalp, which was recalcitrant
to surgical control; clear margins were unable to be
achieved, despite multiple surgical excisions. This case was
managed in a multidisciplinary setting and underwent postoperative radiotherapy.
We recommend early referral to a tertiary centre with a
multidisciplinary approach where careful consideration of the need for negative microscopic margins must be
weighed against the morbidity of multiple excisions and
delayed definitive radiotherapy.