Squamous Cell Carcinoma

A 1-cm, tan-brown lesion had developed years earlier at the posterior helix of a 61-year-old man’s right ear. Central ulceration and crusting were noted on the papule. The patient sought medical evaluation when the lesion became nodular and began to flake. The lesion was excised; pathologic examination identified a well-differentiated squamous cell carcinoma. The neoplasm extended to the deepest margin of the excision; all other margins were free of tumor. The cancer had developed in an actinic solar keratosis with clearly evident basophilic degeneration of dermal collagen( attributed to sun exposure. The patient had worked outdoors most of his life. This patient’s ear will be closely monitored for any signs of recurrence, which can be promptly treated by re-excision or radiation. Regular skin examinations and sunscreen use were strongly recommended. (Case and photograph courtesy of Dr Robert P. Blereau.)