What are Squamous Cell Carcinomas?

Squamous cell carcinomas (SCC) are the second most common form of skin cancer, right behind basal cell carcinomas. They arise from uncontrolled proliferation of the squamous cells, which comprise a large part of the epidermis, the upper layers of the skin. Squamous cell carcinomas can vary in appearance; they are often red sores or patches with a scaly crust. Some might be elevated, or become open sores over time.

This skin cancer is the result of cumulative damage from exposure to the sun and ultraviolet light, collected over many years. As a result, squamous cell carcinomas can occur anywhere on the body but are most often found on areas with frequent and regular exposure to the sun’s rays, such as the head, neck, and hands, as well as on the lower legs for women. Also, individuals who use tanning beds are at much greater risk of developing squamous cell carcinomas. This form of skin cancer typically occurs in individuals between ages 50 and 70, and those with fair skin are most susceptible to developing it.

Squamous cell carcinomas are typically not life-threatening and, with early diagnosis and intervention, are very curable. Left unchecked, however, this cancer has the potential to metastasize and spread to other parts of the body, potentially causing serious detrimental consequences.

Treatment of Squamous Cell Carcinomas

Squamous cell carcinoma lesions are malignant lesions that do posses the ability to metastasize (spead to other parts of the body); as such, these lesions are not only notorious for growing both locally and destroying all structures in their vicinity but also for having the capacity to skip to distant sites. Consequently, it is important to excise these lesions with generous surrounding normal tissue (usually a minimum of 5mm) in order to ensure clear margins. When squamous cell carcinomas are located in areas of skin laxity such as in the arms, legs, and torso, a bi-elliptical (football shaped) excision usually suffices. Excisions must be performed down through the skin as well as the underlying fat to ensure that the cancer has been removed entirely. All such excisions are sent to our laboratory where they will be analyzed over 72 hours (permanent pathology analysis). When squamous cell carcinomas are larger (usually 2 cm or greater) or if they are located on the face, nose, ears, lips, neck, scalp, hands, and feet, they are analyzed by MOHS or frozen section analysis.

MOHS or frozen section analysis allows for the excised tissue to be evaluated immediately while the patient is at the office. Although this process is very arduous, the frozen section biopsy is the mainstay of Cosmetic Plastic Surgery Institute, as it allows our skin cancer patients to be cleared of their cancer during their procedure. Thus, if you are scheduled for MOHS or frozen section surgery you should expect to have your cancer removed entirely (termed cleared) as well as be put back together (defect repaired) in an aesthetically pleasing manner all in one visit. Your plastic surgeon, Dr. Mowlavi, has performed over a thousand frozen sections and subsequent closures with flaps and will detail to you your expected results.

Finally, as squamous cell carcinoma lesions possess an ability to skip (metastasize), it is prudent to evaluate local lymph node basins by clinical examination in order to detect an enlarged lymph node, which might be an indicator of a lesion that has skipped or metastasized. For patients with lesions larger than 2cm or for patients with squamous cell carcinoma over the lower lip, and patients with enlarged nodes, a radiologic body scan (PET SCAN) may be recommended to rule out metastasis. When enlarged nodes are detected by either clinical examination or by PET SCAN, node retrieval may be necessary in order to rule out metastasis. The recommended procedure will be explained to you during your initial consultation with Dr. Mowlavi.

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How our patients feel about us:

He made me very comfortable... Dr Mowlavi and his staff are exceptional. From the 1st phone call to the post op visits, everyone was extremely friendly and eager to answer any and all of my questions. I knew at my consultations that Dr Mowlavi would be my choice, he made me very comfortable and spent a lot of time explaining the options to me. Dr Mowlavi is an intelligent , kind , personable professional, with a great bedside manner.I am so pleased with the results.

M. T. Laguna Niguel, CA

The staff listens to what you have to say... The office and staff are very comforting and relaxed. Dr. Mowlavi and James are a perfect team and the best medical providers I have had the pleasure of being treated by. The staff listens to what you have to say therefore the outcome is positive.

Heidi M. Laguna Niguel, CA

Fast, flawless, and painless... Dr. Mowlavi is a great doctor! I took my charge here twice for a skin cancer operation. Both surgeries were fantastic. They were fast, flawless, and painless. My charge had a similar operation from a different doctor prior to Dr. Mowlavi, and the surgeries were botched. It took forever for the wounds to heal, not to mention, it left an unsightly and indelible scar on my charges back. That is the reason why we had to use Doctor Mowlavi who finally did an amazing job! All I can say is that Dr. Mowlavi is a true expert on cosmetic surgery. He is very efficient in whatever he does. My charge is now very delighted of the outcome of his skin cancer operation.

Jon B. Anaheim, CA

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