What is the treatment for basaloid squamous cell carcinoma (BSCC) diagnosed on a shave biopsy from the forehead?

From the Guidelines

The treatment for basaloid squamous cell carcinoma (BSCC) diagnosed on a shave biopsy from the forehead typically involves complete surgical excision with clear margins, with Mohs micrographic surgery being the preferred approach due to its precision in removing the tumor while preserving healthy tissue. This approach is supported by the guidelines of care for the management of cutaneous squamous cell carcinoma, which emphasize the importance of surgical treatment modalities, such as surgical excision, in the management of cSCC 1. The procedure involves removing the visible tumor and thin layers of surrounding tissue, which are immediately examined under a microscope until all cancer cells are removed.

Some key considerations in the treatment of BSCC include:

• The need for complete surgical excision with clear margins to minimize the risk of recurrence and metastasis
• The use of Mohs micrographic surgery as the preferred approach due to its precision and tissue-sparing capabilities
• The importance of close follow-up, with skin examinations every 3-6 months for at least the first two years, due to the aggressive nature of BSCC
• The potential need for adjuvant radiation therapy in cases where surgery is not feasible or for high-risk tumors

It is worth noting that while older guidelines, such as those published in 2002, also recommend surgical excision as the treatment of choice for cutaneous SCC 1, the more recent guidelines from 2018 provide a more comprehensive overview of the management of cSCC, including the use of Mohs micrographic surgery and the importance of considering factors such as recurrence rate, preservation of function, and patient expectations when choosing a treatment approach 1.

From the Research

Treatment for Basaloid Squamous Cell Carcinoma

The treatment for basaloid squamous cell carcinoma (BSCC) diagnosed on a shave biopsy from the forehead is not explicitly stated in the provided studies. However, some general information about BSCC and its treatment can be gathered:

• BSCC is a variant of squamous cell carcinoma with a potentially poorer survival rate than classical squamous cell carcinoma 2.
• The aggressiveness and outcome of BSCC compared to squamous cell carcinoma are still debated, and more studies are needed to draw conclusions 2.
• For basal cell carcinoma, shave biopsy can be curative in some cases, with 15% of patients not having residual tumor after surgical treatment 3.
• BSCC is a biologically high-grade tumor with a propensity for nodal and systemic metastases, and its treatment may involve surgical excision and possibly other therapies 4.

Diagnostic Techniques

The diagnostic techniques for basal cell carcinoma and squamous cell carcinoma include:

• Shave biopsy and punch biopsy, which have equivalent diagnostic accuracy rates for subtype diagnosis 5.
• New diagnostic imaging techniques such as dermoscopy and reflectance confocal microscopy, which can increase diagnostic accuracy and aid in early recognition and monitoring of treatments 6.

Treatment Approaches

The treatment approaches for squamous cell carcinoma include:

• Surgical excision, which remains the gold standard for diagnosis and treatment 6.
• Innovative treatments such as epidermal growth factor receptor inhibitors and immune checkpoint inhibitors for locally advanced and metastatic SCC 6.