June 4, 2019


Case: A 79-Year-Old Male With Metastatic CSCC

April 2016

  • A 79-year-old male presented to dermatologist with a large ulcerative lesion on clavicle; he reported lesion first appeared 5 months ago while living in Florida for the winter
  • Diagnosed with localized cutaneous squamous cell carcinoma
  • Standard surgical excision performed with 4 mm clinical margins; postoperative margins negative

May 2018

  • Patient returns to dermatologist for follow-up c/o multiple lesions on shoulder and neck around the site of prior excision
  • PE:
    • Multiple visible, ulcerated lesions, approximately 2-3cm in diameter; suspected tumor depth >5mm
    • Multiple palpable nodes ~2cm
  • Imaging confirmed 7 mm invasion into subcutaneous fat; parotid nodal involvement
  • Biopsy confirmed cutaneous squamous cell carcinoma, poorly-differentiated
  • Diagnosis: Metastatic cutaneous squamous cell carcinoma
  • Stage IV: T3N2M0
  • Patient started on cemiplimab