Giant squamous cell carcinoma of the scalp

We report the case of a 43-year-old male with a history of pulmonary tuberculosis cured one year previously and a 25-year-old history of smoking. The patient presented with a tumor of the scalp that had been evolving since the age of thirteen years, gradually increasing in size, neglected by the pat...

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Main Authors: Soumaya Hamich (Author), Fatima Zahra El Gaitibi (Author), Kaoutar Znati (Author), Meriem Meziane (Author), Nadia Ismaili (Author), Laila Benzekri (Author), Karima Senouci (Author)
Format: Book
Published: Our Dermatology Online, 2022-01-01T00:00:00Z.
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Summary:We report the case of a 43-year-old male with a history of pulmonary tuberculosis cured one year previously and a 25-year-old history of smoking. The patient presented with a tumor of the scalp that had been evolving since the age of thirteen years, gradually increasing in size, neglected by the patient. An examination revealed a giant tumor of the occipital area (Fig. 1), 15 × 8 cm in size, which was protruded and ulcerated, with thick, hard edges. On biological assessment, a hemogram revealed microcytic hypochromic anemia at 2.9 g/dL. Ferritin was at 4 ng/mL. HIV serology was negative. A skin biopsy revealed a mature, well-differentiated, infiltrating squamous cell carcinoma (Fig. 2). A CT scan of the brain revealed a poorly limited subgalactic parietooccipital lesion process, with bone lysis and endocranial extension and invasion of the upper longitudinal sinus. Ultrasonography of the lymph node area revealed bilateral axillary and inguinal adenopathies with an infracentimetric fatty hilum. The immediate management was to transfuse the patient with three red blood cells. Control hemoglobin was 7.7 g/dl. The patient, then, received external radiotherapy but was lost to follow-up. Squamous cell carcinoma is the second most common skin cancer [1], occurring in elderly patients with a clear phototype on sun-exposed areas. Its frequency is increasing and correlates with sun exposure [1]. It may reach enormous sizes if neglected and not treated in its early stages. The most common causes of a delayed diagnosis are low socioeconomic status, poor personal hygiene, and fear of the diagnosis and of its possible consequences [2]. Giant carcinomas are defined by a diameter exceeding 5 cm [3]. They pose a higher risk of complication and mortality. The invasiveness of these tumors depends on the size, anatomical location, and histological subtype. Their treatment is difficult because, even with extensive surgical removal, recurrence and metastasis are frequent [3].
Item Description:2081-9390
10.7241/ourd.20221.25