Cutaneous Squamous Cell Carcinoma of the Columella with an Unusual Revelation: A Rare Case Report and A Literature Review of Its Staging and Management Challenges

Abstract

Background: Squamous cell carcinoma (SCC) arising from the nasal vestibule is a rare condition accounting for about 1% of head and neck malignancies. SCC develops as a result of exposure to sunlight and ultraviolet radiation, toxic agents, scars, compromised immune status, and genetic defects.It is characterized by several particularities concerning clinical presentation, staging and treatment. Through this case presentation, we report an unusual mode of revelation of a SCC of the collumella,eventually, we discuss through a brief review of the literature its various staging and management features. Case presentation:We report a rare case of cutaneous squamous cell carcinoma of thecollumella in a 43-year-old Moroccan male who presented at first for an abscess of the columella of 10 days duration. After incision-drainage of the abscess, the histological examination of the biopsy specimen revealed cutaneous SCC. Complete surgical resection and bilateral lymph node dissection were performed. Reconstruction of columella defect was accomplished by a forehead flap after confirming disease-free surgical margins. Later, the patient underwent radiation therapy. There were no signs of recurrence or metastases at 3 years postoperatively. Conclusion:despite being superficial and accessible, SCC's diagnosis may be late due to its unspecific clinical presentation which causes an enormous problem of surgical management, because the removal of these tumors emerging in the face and the reconstruction of the extensive mutilations that follow, result in disastrous aesthetic outcomes and social consequences. Hence, the need to recognize symptoms in order to diagnose early for a better management and less damages.