Nonsurgical Treatment for Invasive Cutaneous Squamous Cell Carcinoma: A Case Study
Posted: Monday, March 9, 2020
Squamous cell carcinoma generally responds well to standard treatments, which include surgical excision and Mohs micrographic surgery. However, for some patients, surgery may be less ideal, such as older patients, those who have large or multiple lesions, or patients who are concerned about scarring or other cosmetic outcomes. A study reported in the Journal of Drugs in Dermatology describes one patient with invasive cutaneous squamous cell carcinoma who was successfully treated medically, without surgical intervention. The study was a collaboration between senior author John Shen, MD, of Shen Dermatology in Temecula, California, and researchers from the University of Miami Miller School of Medicine.
An 86-year-old man with no history of skin cancer presented with a papule behind his right ear. A biopsy confirmed the presence of invasive squamous cell carcinoma. The patient, concerned about the cosmetic adverse effects of surgery, requested an alternate course of treatment. He was treated with a combination of topical 5% imiquimod cream, 2% fluorouracil solution, and 0.1% tretinoin cream for 5 nights per week, with an ultimate goal of 30 applications. He also received local cryotherapy and was evaluated in the clinic every 2 weeks.
The patient reported burning pain at the site and thus was unable to finish the full course of treatment; he completed a total of 24 applications. After 15 months, the patient had a dermal scar at the site; upon biopsy, no residual carcinoma was found.
“Prospective randomized-controlled clinical trials to assess the role of combination topical treatment for invasive [squamous cell carcinoma] are warranted,” the authors concluded.
Disclosure: The authors reported no conflicts of interest.