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Risk Stratifying Cutaneous Squamous Cell Carcinoma in Organ Transplant Recipients
  • Guidelines from the International Transplant-Skin Cancer Collaborative (ITSCC) suggests that Squamous Cell Carcinoma in transplant patientss should be stratified into low and high risk lesions(5)
  • Subsequent treatment and follow-up intervals should be based upon on type of Squamous Cell Carcinoma
  • High risk lesions are at increased risk for recurrence and metastasis

Characteristics of Low Risk Squamous Cell Carcinoma:

  • Size:
    • <0.6 cm face (excepts cheek and forehead)
    • <1.0 cm cheeks, forehead, neck, and scalp
    • <2.0 cm trunk and extremities
  • Slow-growing lesion
  • Distinct, well-defined margins
  • Lack of satellite lesions
  • Histology:
    • in situ lesion
    • Keratoacanthoma type
    • Well-differentiated
    • Invasion limited to papillary dermis
    • Absence of neurtransplant patientsopism
    • Absence of perivascular or intravascular invasion

Characteristics of High Risk Squamous Cell Carcinoma:

  • Size
    • >0.6cm face (excepts cheek and forehead)
    • >1.0cm cheeks, forehead, neck, and scalp
    • >2.0 cm trunk and extremities
  • Indistinct clinical borders
  • Rapid growth
  • Multiple lesions
  • Ulceration
  • Recurrence after previous treatment
  • Location:
    • central face, eyelids, eyebrows, periorbital area, nose, lips, chin, mandible, preauricular and postauricular areas, temple and ear, genitalia, and digits
    • Occurance in a scar, in an area of chronic inflammation, or in a field of prior radiation therapy
  • Histology:
    • Poor differentiation
    • Deep extension of the tumor into SQ fat
    • Perineural invasion/inflammation
    • Perivascular or intravascular invasion
Updated: May 4, 2007
This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.
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