Invasive Squamous Cell Carcinoma

September 2, 2008

A biopsy of this asymptomatic lesion showed invasive squamous cell carcinoma without obvious perineural involvement. The lesion was excised with Mohs surgery, with good cosmetic outcome.

This asymptomatic lesion had developed insidiously on the foreleg of an 82-year-old woman. She had a history of multiple non-melanoma skin cancers, most likely related to extensive sun exposure throughout life.

The 2.2 x 1.5-cm nodule was rockhard with a thick, scaly crust. Inguinal lymph nodes were not enlarged.

A biopsy of the lesion showed invasive squamous cell carcinoma without obvious perineural involvement. The patient was referred for excision with staged microscopic control (Mohs surgery). The lesion was removed after 3 sequential step excisions, and the defect closed primarily.

The patient was pleased with the cosmetic outcome. She remains under close observation for possible recurrence and for skin cancer in general.