Spectrum of Cutaneous Squamous Cell Carcinoma: A Case Study Emphasizing Diagnostic Vigilance

Abstract

Background: Cutaneous squamous cell carcinoma (C-SCC) is the second most common skin malignancy worldwide, with an increasing incidence. Although often indolent, it can exhibit local invasion and metastasis. Its varied morphology may mimic benign dermatologic conditions, delaying diagnosis and management. Objectives: To highlight the clinical heterogeneity of C-SCC through diverse presentations, emphasizing the need for diagnostic vigilance. Methods: A case series of five patients with histopathologically confirmed C-SCC was analyzed. Each case was evaluated for site, predisposing factors, morphology, and management outcomes. Case 1: Post-burn scar ulcer (Marjolin’s ulcer) treated with excision and grafting. Case 2: Groin and penile ulcer with nodal metastasis; patient succumbed during chemotherapy. Case 3: Keratoacanthoma with adjacent SCC on leg, managed with retinoids. Case 4: Inguinal lesion post-hair-plucking trauma; well-differentiated SCC. Case 5: Verrucous carcinoma over condyloma acuminata; partial penectomy performed. Results: Lesions arose in varied contexts—over scars, traumatic or infectious sites, and pre-existing dermatoses. Conclusion: C-SCC may masquerade as benign or inflammatory dermatoses. Early biopsy and histopathological confirmation are crucial for timely intervention and prevention of metastasis. Recommendations: Clinicians should maintain a high index of suspicion for non-healing, indurated, or atypical cutaneous lesions.