In squamous cell carcinoma of the skin (PEC) – colloquially called spinocellular carcinoma – (synonyms: epithelioma spinocellulare; cutaneous squamous cell carcinoma (SCC); spinalioma; spinocellular carcinoma; spiny cell carcinoma; Engl. (ICD-10 C44.9: Spinalioma of the skin – squamous cell carcinoma) is a malignant neoplasm of the skin that originates from the squamous epithelium. It is a malignant proliferation of keratinocytes (horn-forming cells) of skin and skin appendages.
PEK grows locally destructive and in about 5% of metastasizes lymphogenically (forms daughter tumors that are scattered through the lymphatic vessels).
Squamous cell carcinoma, together with basal cell carcinoma, is also known as “white skin cancer“.
PEK develops in most cases after months to years on the basis of actinic keratoses or Bowen’s disease.
Squamous cell carcinoma of the skin (PEK) belongs to the non-melanoma skin cancer (NMSC).
Spinocellular carcinoma, basal cell carcinoma and actinic keratoses as in situ carcinomas are increasingly also called keratinocytic carcinomas (KC).
Particularly frequently affected are fair-skinned people and here the especially sunlight-sensitive skin types (light factor I and II according to Fitzpatrick).
The following histological forms of squamous cell carcinoma of the skin (PEC) can be distinguished:
- Acantholytic (pseudoglandular) squamous cell carcinoma of the skin.
- (Desmoplastic squamous cell carcinoma – not yet included in the international classification) [higher risk of recurring locally].
- Lymphoepithelioma-like squamous cell carcinoma of the skin.
- Squamous cell carcinoma with horn formation
- Spindle cell squamous cell carcinoma of the skin (aggressive behavior).
- Verrucous squamous cell carcinoma of the skin (prognostically favorable).
All histologic subtypes of squamous cell carcinoma are treated similarly.
Squamous cell carcinoma of the skin (PEK) is the second most common tumor of the skin after basal cell carcinoma (BZK; basal cell carcinoma).
Sex ratio: Men are more frequently affected than women.
Peak incidence: The maximum incidence of squamous cell carcinoma of the skin (PEK) is between the ages of 70 and 80.
The incidence (frequency of new cases) is about 170 cases per 100,000 population per year for men and about 93 cases per 100,000 population per year for women in Europe and is higher in Australia and New Zealand.
Course and prognosis: Squamous cell carcinoma of the skin (PEK) occurs mainly on light-exposed areas such as the face, hands or forearms, and on mucous membranes. Therefore, it is usually detected early. The tumor grows locally destructive and does not metastasize frequently. If it is a small PEK (diameter < 2 cm), generally no metastases (daughter tumors) are yet detectable in lymph nodes or organs.If metastasis occurs, it usually occurs within the first two years after diagnosis. The prognosis worsens significantly if metastases are already present at diagnosis. PEK is often recurrent, so consistent follow-up is important.In the case of recurrence, the 1-year survival rate drops to 43%. The mortality rate (number of deaths in a given period, based on the number of the population in question) is approximately 0.38%.
The 5-year survival rate ranges from 60-80% for non-metastatic tumors and from 25-50% for advanced metastatic tumors.
