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Squamous Cell Carcinoma

Smirniotopoulos, M.D. JGSM - MedPix (2014)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Squamous Cell Carcinoma

History: A 60+ y/o male with an left periorbital mass. With the use of a medical interpreter, I slowly was able to collect a basic history. Approximately 12 to 18 months prior to presentation, the patient states he had a "small bump around his left eye". Due to poor medical resources in XX, the patient states he traveled to YY where he had surgery. His eye was surgically removed and he stated, "no cancer". He returned to XX from YY and states the small lesion slowly grew into what was noted on exam today. The lesion bleeds, but is minimally painful. He states he has been having progressively worsening right sided temporal headaches. PMHX: None reported PSHX: enucleation surgery OD eye RX: None ALL: NKDA

Findings: It appears that the lids are consumed by a diffusely infiltrative neoplastic process, with areas of marked thickening, ulceration and necrosis, giving the appearance of a rodent ulcer.

Ddx: Squamous cell carcinoma Basal cell carcinoma Primary Melanoma lymphoma/leukemia, leiomyosarcoma/leiomyoma optic nerve tumor (glioma) meningioma, Schwannoma, Neurofibroma lacrimal tumors etc, vs metastatic lesion (smoker? Lung) Paranasal sinus tumor invasion. Lower on the ddx: sebaceous cell carcinoma, other adenocarcinoma, granular cell tumor, langerhans histiocytosis, fibrous histiocytoma, granulocytic sarcoma, myeloma, osteosarcoma, sarcoidosis, amyloid nodular, hemangiopericytoma.

Dxhow: Clinical

Exam: V/S unremarkable. VA in OS eye- could not be tested with snellen but appeared able to see small pictured objects. L periorbital area: noted to have a large mass as noted in attached picture. The orbit was filled with gauze. Neuro: CN exam- I not tested. II in OS eye grossly unremarkable. III, IV, VI in OS eye unremarkable. V, VII- sensation absent over mass lesion. Able to wrinkle forehead bilaterally. Smile symmetrical. VIII, IX, X- R ear was occluded with cerumen with some involvement of the mass of the anterior ear canal. Tongue and palatal movement unremarkable.

No MeSH data available.


It appears that the eyelids are consumed by a diffusely infiltrative neoplastic process, with areas of marked thickening, ulceration and necrosis, giving the appearance of a rodent ulcer. In the US this would most typically be a basal cell carcinoma or squamous cell Ca (SCCA). In your region, sebaceous cell Ca is also very prevalent and may actually be more common than either basal cell or squamous cell. I suspect the orbit proper is probably full of tumor as well.
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MPX2045_synpic59991: It appears that the eyelids are consumed by a diffusely infiltrative neoplastic process, with areas of marked thickening, ulceration and necrosis, giving the appearance of a rodent ulcer. In the US this would most typically be a basal cell carcinoma or squamous cell Ca (SCCA). In your region, sebaceous cell Ca is also very prevalent and may actually be more common than either basal cell or squamous cell. I suspect the orbit proper is probably full of tumor as well.


Squamous Cell Carcinoma

Smirniotopoulos, M.D. JGSM - MedPix (2014)

It appears that the eyelids are consumed by a diffusely infiltrative neoplastic process, with areas of marked thickening, ulceration and necrosis, giving the appearance of a rodent ulcer. In the US this would most typically be a basal cell carcinoma or squamous cell Ca (SCCA). In your region, sebaceous cell Ca is also very prevalent and may actually be more common than either basal cell or squamous cell. I suspect the orbit proper is probably full of tumor as well.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2045&req=5

MPX2045_synpic59991: It appears that the eyelids are consumed by a diffusely infiltrative neoplastic process, with areas of marked thickening, ulceration and necrosis, giving the appearance of a rodent ulcer. In the US this would most typically be a basal cell carcinoma or squamous cell Ca (SCCA). In your region, sebaceous cell Ca is also very prevalent and may actually be more common than either basal cell or squamous cell. I suspect the orbit proper is probably full of tumor as well.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Squamous Cell Carcinoma

History: A 60+ y/o male with an left periorbital mass. With the use of a medical interpreter, I slowly was able to collect a basic history. Approximately 12 to 18 months prior to presentation, the patient states he had a "small bump around his left eye". Due to poor medical resources in XX, the patient states he traveled to YY where he had surgery. His eye was surgically removed and he stated, "no cancer". He returned to XX from YY and states the small lesion slowly grew into what was noted on exam today. The lesion bleeds, but is minimally painful. He states he has been having progressively worsening right sided temporal headaches. PMHX: None reported PSHX: enucleation surgery OD eye RX: None ALL: NKDA

Findings: It appears that the lids are consumed by a diffusely infiltrative neoplastic process, with areas of marked thickening, ulceration and necrosis, giving the appearance of a rodent ulcer.

Ddx: Squamous cell carcinoma Basal cell carcinoma Primary Melanoma lymphoma/leukemia, leiomyosarcoma/leiomyoma optic nerve tumor (glioma) meningioma, Schwannoma, Neurofibroma lacrimal tumors etc, vs metastatic lesion (smoker? Lung) Paranasal sinus tumor invasion. Lower on the ddx: sebaceous cell carcinoma, other adenocarcinoma, granular cell tumor, langerhans histiocytosis, fibrous histiocytoma, granulocytic sarcoma, myeloma, osteosarcoma, sarcoidosis, amyloid nodular, hemangiopericytoma.

Dxhow: Clinical

Exam: V/S unremarkable. VA in OS eye- could not be tested with snellen but appeared able to see small pictured objects. L periorbital area: noted to have a large mass as noted in attached picture. The orbit was filled with gauze. Neuro: CN exam- I not tested. II in OS eye grossly unremarkable. III, IV, VI in OS eye unremarkable. V, VII- sensation absent over mass lesion. Able to wrinkle forehead bilaterally. Smile symmetrical. VIII, IX, X- R ear was occluded with cerumen with some involvement of the mass of the anterior ear canal. Tongue and palatal movement unremarkable.

No MeSH data available.