Squamous cell carcinoma of the skin: Accuracy of clinical diagnosis and outcome of follow‐up in Australia

Nixon, Rosemary; Dorevitch, A.P.; Marks, R.

doi:10.5694/j.1326-5377.1986.tb115884.x

Cited by 67 publications

(34 citation statements)

References 8 publications

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“…The family practitioners in this study achieved comparable diagnostic accuracy to those reported in other population‐based studies for dermatologists and surgeons for diagnosing BCC and SCC 11,16 . Positive predictive values were very high for benign nevi and other benign lesions, but were lower for dysplastic and malignant lesions.…”

Section: Discussionsupporting

confidence: 68%

Diagnostic accuracy in skin cancer clinics: the Australian experience

2006

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Section: Discussionsupporting

confidence: 68%

Diagnostic accuracy in skin cancer clinics: the Australian experience

2006

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“…Numerous studies have confirmed the inaccuracy of preoperative clinical diagnosis, by even experienced observers. [4][5][6] In one study the clinical diagnosis of SCC of the skin was confirmed in 51% of cases. 4 Clinical diagnosis of BCC affords better results, with Kersten et al 5 obtaining a diagnostic accuracy of 92.8%.…”

Section: Discussionmentioning

confidence: 96%

Squamous cell carcinoma of the eyelids

Donaldson¹,

Sullivan²,

Whitehead³

et al. 2002

British Journal of Ophthalmology

157

141

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Aim: To review the clinical features, management, and outcomes of surgical treatment of eyelid squamous cell carcinoma (SCC). Methods: A retrospective review of all eyelid SCCs treated between 1992 and 2001. Results: 51 cases were identified in 50 patients. Patient ages ranged from 26 to 93 years, with a mean age of 65 years. 33 patients were male and 17 were female. The lesion was found on the lower lid in 31 cases, upper lid in five cases, lateral canthus in six cases, and medial canthus in nine cases. Perineural invasion was found in four patients, and orbital invasion in three patients. Recurrence occurred in one patient. Treatment was by complete excision with histological confirmation of clear margins. Exenteration was required in three patients. No patients developed lymph node or distant metastases. One patient, who declined treatment, died as a result of the tumour. Mean follow up was 31.1 months. Conclusions: Eyelid SCC is a relatively uncommon, but potentially fatal disease. However, if detected early and treated adequately, the prognosis is generally excellent. Treatment by complete excision with histological confirmation of tumour clearance is recommended. Perineural spread is an adverse prognostic sign, which may require postoperative radiotherapy. Orbital invasion is a rare complication but, if recognised early, can be treated effectively with exenteration. Because presentation varies and histological examination is required for accurate diagnosis, any suspicious lesion occurring on the eyelids should be excised or biopsied. All patients with eyelid SCC should be advised of the risk of recurrent or new tumours and encouraged to attend lifelong follow up. Prevention remains of prime importance in minimising the morbidity and mortality of these lesions. S quamous cell carcinoma (SCC) is an invasive epithelial malignancy showing keratinocytic differentiation. It is the second most common malignant neoplasm of the eyelids, 1 comprising 5-10% of all eyelid malignancies. The incidence for eyelid SCC has been reported to be between 0.09 and 2.42 cases per 100 000 population.2 Extrinsic risk factors include ultraviolet light/actinic damage and exposure to arsenic, hydrocarbons, radiation, or immunosuppressive drugs. 3Intrinsic risk factors include albinism, pre-existing chronic skin lesions and genetic skin disorders such as xeroderma pigmentosum and epidermodysplasia verruciformis.Because of the significant morbidity of these lesions and in order to better define the clinical features and treatment outcomes, and to make management recommendations, we conducted a review of all eyelid SCCs treated over a 9 year period. METHODSA retrospective medical record review was conducted of all eyelid squamous cell carcinomas seen in the practice of one of the authors (TJS) in the 9 years from 1992 to 2001. Cases were identified by searching the practice records of the author and hospital and pathology laboratory computerised databases. Included were all lesions originating on the eyelids or canthi with a pathologica...

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“…Numerous studies had confirmed the inaccuracy of preoperative clinical diagnosis, even by experienced observers. [5][6][7][8] Donaldson et al 4 reported that 62.7% of the lesions were correctly identified as squamoproliferative lesions preoperatively.…”

Section: Discussionmentioning

confidence: 99%

Invasive squamous cell carcinoma of the eyelids and periorbital region

Soysal¹,

Markoç²

2006

British Journal of Ophthalmology

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Aim: To review the clinical and histopathological features, treatment and outcomes of squamous cell carcinoma of the eyelids. Methods: 76 patients with eyelid squamous cell carcinoma treated in an oncology referral hospital between 1997 and 2006 were reviewed retrospectively. Age, sex, risk factors, duration of symptoms, size and location of lesion, previous recurrences, presence of perineural invasion (PNI) and orbital invasion, histological subtype, inflammatory response of peritumoral tissue were recorded and analysed. Results: Mean (SD) lesion size was 2.4 (0.36) mm. 27 (35.5%) cases were previously recurrent. The most common histological subtype was well differentiated (59.2%). The rates of PNI and orbital invasion were 23.8% and 43.4%, respectively. 63 patients underwent surgery, whereas others were treated with external radiotherapy or chemotherapy. Recurrence or presence of residual tumour rate was 22.4%, most of them had orbital invasion. Regional lymph node metastasis was detected in 5 (6.6%) cases. Conclusions: Advanced deep local invasion was not rare in this study, as a result of treatment delay and previous inadequate treatments. Adverse prognostic factors associated with secondary orbital invasion are previous recurrences, longer duration of lesion, larger lesion size, and presence of PNI. Well-differentiated subtype and strong inflammatory response are good prognostic factors.S quamous cell carcinoma (SCC) is the second most common malignancy of the eyelid skin. 1 In the eyelid, although it occurs much less commonly than basal cell carcinoma, it is more aggressive and invasive than basal cell carcinoma. If treatment is delayed, periocular SCC can metastasise and invade the orbital and intracranial structure, hence it has a considerable potential of mortality and morbidity. 2 We conducted a retrospective study to review the clinical, histopathological and treatment features, and the outcome of eyelid SCCs that was seen in an oncology referral hospital over a period of 9.5 years.

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Squamous cell carcinoma of the skin: Accuracy of clinical diagnosis and outcome of follow‐up in Australia

Cited by 67 publications

References 8 publications

Diagnostic accuracy in skin cancer clinics: the Australian experience

Diagnostic accuracy in skin cancer clinics: the Australian experience

Squamous cell carcinoma of the eyelids

Invasive squamous cell carcinoma of the eyelids and periorbital region

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