From the Guidelines
Imaging is not recommended for pathology-confirmed superficial squamous cell carcinoma of the inner thigh, unless there are high-risk features or clinical suspicion of metastasis. For localized, superficial SCCs without high-risk features, clinical examination is typically sufficient for management 1. The provided evidence does not support routine imaging for superficial SCCs, as the risk of metastasis is low (less than 2%) 1.
Key Considerations
- Clinical examination is sufficient for management of localized, superficial SCCs without high-risk features
- Imaging may be considered if there are concerning features such as large tumor size (>2 cm), deep invasion (>6 mm), poor differentiation, perineural invasion, or clinical suspicion of regional lymph node involvement
- Treatment typically involves complete surgical excision with appropriate margins (usually 4-6 mm) or other destructive techniques like electrodessication and curettage for very superficial lesions
- Regular follow-up examinations are important to monitor for local recurrence or new skin cancers, typically every 3-6 months for the first 2 years, then annually thereafter
Evidence Review
The evidence from 1 and 1 suggests that imaging is not necessary for superficial SCCs without high-risk features. However, the most recent and highest quality study 1 provides guidance on the management of cutaneous squamous cell carcinoma, which supports the recommendation against routine imaging for superficial SCCs.
Management Approach
The management approach for superficial SCCs should focus on complete surgical excision or other destructive techniques, with regular follow-up examinations to monitor for local recurrence or new skin cancers. Imaging should only be considered if there are high-risk features or clinical suspicion of metastasis, as supported by the evidence from 1.
From the Research
Imaging Recommendations for Pathology Confirmed Superficial Squamous Cell Carcinoma
- The provided studies do not directly address the specific scenario of superficial squamous cell carcinoma of the inner thigh, but they offer insights into the general approach to squamous cell carcinoma (SCC) diagnosis and staging.
- According to 2, the management of patients with cSCC involves a multistep approach, including clinical characteristics, dermoscopy, reflectance confocal microscopy, and histopathology for diagnosis, and physical examination, ultrasound, and/or computed tomography or magnetic resonance imaging for assessing tumor spread.
- 3 mentions that histopathology and correct surgical excision remain the gold standard for the diagnosis and treatment of SCC, but new diagnostic imaging techniques like dermoscopy and reflectance confocal microscopy can increase diagnostic accuracy.
- The use of imaging techniques such as PET/CT is discussed in 4 and 5 for locally advanced oral squamous cell carcinoma and initial diagnosis and staging with PET/CT, respectively, but these studies do not specifically address superficial SCC of the inner thigh.
- 6 explores the potential role of PET/MRI in head and neck squamous cell carcinoma, highlighting the complementary information provided by PET/CT and MRI, but this is not directly applicable to the inner thigh scenario.
- Based on the available evidence, it appears that imaging may be recommended for assessing tumor spread and staging in patients with squamous cell carcinoma, but the specific recommendations for superficial SCC of the inner thigh are not clearly outlined in the provided studies.