Cutaneous SCCa



Cutaneous SCCa


Nayela Keen, MD

Christine M. Glastonbury, MBBS









(Left) Typical case of an infiltrative skin squamous cell carcinoma. Clinical photograph illustrates nodular mass image on left side of the nose, adjacent to the nares, with central ulceration. Thickened adjacent skin indicates local infiltration of tumor image. (Right) Axial NECT in the same patient shows the mass image but also illustrates the infiltrative nature of this lesion as it extends through the nose into nares image but also infiltrates more superiorly and bilaterally subcutaneously image.






(Left) Axial T2 FS MR in the same patient reveals the nodular lesion image and better illustrates the infiltrative margins extending into the nares image. The tumor is diffusely homogeneous in signal and relatively low on T2. (Right) Axial T1WI C+ FS MR in the same patient shows mild heterogeneous enhancement of the lesion image with infiltrating margins image. The septal cartilage appears intact image. No facial, parotid, or jugular chain adenopathy was evident on evaluation of the rest of the neck.



TERMINOLOGY


Abbreviations



  • Cutaneous squamous cell carcinoma (cSCCa)


Synonyms



  • In situ cSCCa, known as Bowen disease


Definitions



  • Skin tumor arising from keratinocytes of epidermis (outer skin layer)


IMAGING


General Features



  • Best diagnostic clue



    • Intraparotid &/or cervical nodes with cutaneous/subcutaneous mass


  • Location



    • Head & neck or extremities (sun-exposed areas)



      • Central zone of face, temple, lips, ear, and scalp


      • Ear and lower lip more prone to cSCCa than basal cell carcinoma (BCCa)


  • Size



    • Variable, both in superficial and deep extent


  • Morphology



    • Variable, ranging from ill-defined skin thickening to discrete cutaneous/subcutaneous mass


CT Findings



  • Soft tissue enhancing mass or subtle skin thickening depending on size of primary tumor



    • Invasion of normal tissues, including bone erosion with more aggressive lesions


  • Nodal disease may be solid or necrotic


MR Findings



  • T1WI



    • Isointense to muscle; can see tumor infiltration within subcutaneous fat


  • T2WI FS



    • Variable, generally hyperintense to muscle


  • T1WI C+ FS



    • Mild to moderate enhancement

Sep 20, 2016 | Posted by in HEAD & NECK IMAGING | Comments Off on Cutaneous SCCa
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