Squamous Cell Carcinoma (SCC) Of The Nasal Tip Skin

Malignant Type of Nose Tip Skin Cancer Presenting as Simple Nevus


Squamous Cell Carcinoma, SCC, The Nasal Tip Skin Cancer, Nose Tumor
A 75-year-old male patient presented with the complaint of a painless, irregular, round-shaped, dark-colored mass lesion at the tip of the nose for 3 months.

In the examination, excisional biopsy was performed under local anesthesia, in office conditions, for a well-defined, rough surface, almost black-shaped, tumoral lesion. In the photos below, there are pre- and post-operative images and the image of the excised part in the pathology container.

Procedure details: Local anesthetic was injected after the cream containing local anesthetic was applied to the tip of the nose. The ovoid-shaped, intact margins were preserved and excision was made. The incision was sutured with 5/0 rapid vicryl suture material (self-melting). Bleeding was controlled. Regular application of local antibiotic cream and wound care techniques were recommended to the patient. The process has been terminated.

The result of the histopathological examination of the patient 1 week later: Well  Differentiated Squamous Cell Carcinoma (SCC)

Squamous Cell Carcinoma, SCC, The Nasal Tip Skin Cancer, Nose Tumor

Squamous Cell Carcinoma, SCC, The Nasal Tip Skin Cancer, Nose Tumor

Squamous Cell Carcinoma, SCC, The Nasal Tip Skin Cancer, Nose Tumor

About The Basal cell carcinoma (BCC) ve Squamous Cell Carcinoma (SCC)

Squamous Cell Carcinoma, SCC, The Nasal Tip Skin Cancer, Nose TumorBasal Cell Carcinoma (BCC) is the most common skin cancer and its incidence is increasing. It is more common in elderly patients (may be due to excessive sun exposure). Basal cell cancer is a skin cancer originating from cells in the non-melanocytic basal layer of the skin. It has a good course, but there is a risk of deformation in the surrounding tissues. For this reason, early diagnosis is important. It got this name because it originates from basal cells in the skin at the junction of the epidermis and dermis, or from the basal cells that cover the inner surface of the accessory elements of the skin (hair follicle, sweat glands, sebaceous glands). BCC usually occurs in sun-exposed areas. Basal cell cancers are seen on the face, scalp and neck at a rate of 85%, and 30% develop in the nose. The rest occurs on the trunk, arms and legs, and very rarely in the hand. It often settles on the skin where the hair follicles are located, develops slowly, does not metastasize to other parts of the body, but metastases to other parts of the body are very rare. 95% of patients are between the ages of 40-79. It is seen almost equally in men and women. Although it is not life-threatening, its treatment and follow-up are important. BCC that has been neglected for too long can spread to the surrounding tissues, jawbones, eyeball, and brain. Since the patient whose photo I shared with you is old and the lesion appeared in the sun-exposed area at the tip of the nose, and the patient did not smoke or drink alcohol, we initially thought it was Basal Cell Cancer as a preliminary diagnosis, but the result was Squamous Cell Carcinoma (SCC) as a result of the pathology.

Squamous Cell Carcinoma, SCC, The Nasal Tip Skin Cancer, Nose Tumor

Squamous Cell Carcinoma (SCC) is a carcinoma that arises from the epidermis, spreading and metastasizing. It can develop both on the skin and on the mucous membranes. It is a very common cancer of the skin, with the exception of basal cell epitheliomas, which for some reason do not count as true cancer. It is an alcohol- and smoking-related tumor. It is often seen in the elderly and men. It is a skin tumor with high mortality. Squamous cell carcinoma does not have a very specific appearance. Usually there is a local hardening first, then a plaque / verrucous papule / nodule / ulcer develops. The borders of the tumor are not very clear, it can crust over time, there is erythema around it, infection and bleeding can be seen. The borders of the lesion at the tip of the nose of the patient I shared with you were clear, the middle was irregular and dark in color. The onset of the tumor may be a non-healing, constantly bleeding fissure or ulcer in areas such as the lip and genital area. Again, the middle part of the nasal lesion of the patient I shared with you was more puffy than the surface. A regional lymphadenopathy near the tumor that is firm, irregular and adherent to the underlying tissues is the first sign of metastasis. Unlike BCC, it can spread by metastasizing to distant organs. Squamous cell carcinoma is graded according to the atypia in their histological structure and the deep spread they show. The degree of cellular differentiation, changes in the shape and size of cells, hyperchromasia, keratinization, and amount of mitosis affect the grade (Grade 1-4). Nasal cavity SCCs are rare tumors. As their grade increases, their tendency to spread and metastasize increases. Squamous cell carcinoma, which may initially be clinically smooth, verricous, papillamatous, or ulcerative, may show induration, inflammation, and extensive ulceration over time. Well-differentiated SCC is referred to as “verrucous cancer”. In these tumors, excision of the tumor with adequate surgical margins and providing local control are the main important factors. In the patient I shared with you, no tumor was found in the surgical margins in the histopathological examination. 

Squamous Cell Carcinoma, SCC, The Nasal Tip Skin Cancer, Nose Tumor

Squamous Cell Carcinoma, SCC, The Nasal Tip Skin Cancer, Nose Tumor

Squamous Cell Carcinoma, SCC, The Nasal Tip Skin Cancer, Nose Tumor

Squamous Cell Carcinoma, SCC, The Nasal Tip Skin Cancer, Nose Tumor

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Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com 
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