Desmoplastic squamous cell carcinoma: case presentation and literature review.
BACKGROUND
Desmoplastic squamous cell carcinoma (DSCC) is a variant of squamous cell carcinoma (SCC) with aggressive histologic and clinical features. DSCC has a 6 to 10 times higher rate of both local recurrence and metastatic spread compared with well-differentiated SCC. Clinical estimation of tumor margins can grossly underestimate both the depth and the peripheral extent of the tumor. Surgery with intraoperative margin control has been recommended. In many cases, postoperative radiotherapy or prophylactic lymph node dissection may be required.


METHODS
A 71-year-old man with a biopsy positive for DSCC involving the left postauricular area was treated with nine-stage Mohs micrographic surgery before the tumor margins were negative.


CONCLUSIONS
There are minimal reports in the literature pertaining to the presentation and treatment of DSCC; therefore, definitive conclusions are difficult. The depth of tumor penetration and peripheral spread of the DSCC presented in this case, however, supports the need for aggressive surgical excision, preferably with intraoperative margin control. To maximize the chance of cure, physicians must be aware of the distinct clinical and histologic features of DSCC and the aggressive treatment required.
Division of Plastic and Reconstructive Surgery, Department of Surgery, University of British Columbia.
Alex
A
Seal
David
D
Zloty
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D054644:Ear Auricle; D004428:Ear Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male