Deeply Invasive Squamous Cell Carcinoma

An 88-year-old woman sought medical attention for a nodule on the anterior surface of her left foreleg that had gradually developed.

Key point: An exophytic nodule with ulceration and some element of surface hyperkeratosis in a geriatric patient is almost always malignant. A biopsy in this case disclosed well-differentiated but deeply invasive squamous cell carcinoma.

Treatment: Moh's micrographic surgery was performed to ensure complete removal. The resulting defect was quite large, but not cosmetically objectionable.

Note: Some 2500 deaths occur in the United States each year from cutaneous squamous cell carcinoma.*-