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Concept
Cutaneous squamous-cell carcinoma
Summary
Cutaneous squamous-cell carcinoma (cSCC), or squamous-cell carcinoma of the skin, also known as squamous-cell skin cancer, is, with basal-cell carcinoma and melanoma, one of the three principal types of skin cancer. cSCC typically presents as a hard lump with a scaly top layer, but it may instead form an ulcer. Onset often occurs over a period of months. Cutaneous squamous-cell carcinoma is more likely to spread to distant areas than basal cell cancer. When confined to the outermost layer of the skin, a pre-invasive, or in situ, form of cSCC is known as Bowen's disease.
The most significant risk factor for cSCC is high lifetime exposure to ultraviolet radiation from the sun. Other risks include prior scars, chronic wounds, actinic keratosis, paler skin that sunburns easily, Bowen's disease, arsenic exposure, radiation therapy, tobacco smoking, poor immune system function, prior basal cell carcinoma, and HPV infection. Risk from UV radiation is related to total exposure, rather than exposure early in life. Tanning beds have become another frequent source of ultraviolet radiation. Risk is also elevated in certain genetic skin disorders, such as xeroderma pigmentosum and certain forms of epidermolysis bullosa. cSCC begins from squamous cells found in the upper layers of the skin. Diagnosis is often based on skin examination, and confirmed by tissue biopsy.
In vivo and in vitro studies have shown that the upregulation of FGFR2, a subset of the fibroblast growth factor receptor (FGFR) immunoglobin family, has a critical role to play in the progression of cSCC cells. Mutations in the TPL2 gene cause over-expression of FGFR2, which activates the mTORC1 and AKT pathways in both primary and metastatic cSCC cell lines. By using a chemical substance, called a "pan FGFR inhibitor", cell migration and cell proliferation in cSCC have been attenuated in vitro.
Avoiding exposure to ultraviolet radiation and the use of sunscreen appear to be effective methods of preventing cutaneous squamous-cell carcinoma. Treatment is typically by surgical removal.
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