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Significance Near Cutaneous Squamous Cell Carcinoma

Barry Leshin, MD; Elizabeth H. Prichard, MD; Wain L. White, MD

Arch Dermatol. 1992;128(5):649-652.

Abstract
Background.—
Discrimination of benign from malignant is fundamental to accurate histologic diagnosis. This article describes a series of nine patients with cutaneous squamous cell carcinoma who were noted to have in the vicinity of their neoplasm seemingly benign but biologically significant dermal granulomatous inflammation to cornified cells (GRC).

Observations.— —
Two patients were reported as having this finding alone on incisional biopsy specimens only to have subsequent biopsy specimens demonstrate bona fide malignant neoplasms. On Mohs' frozen sections, four patients were noted to have GRC without concomitant tumor and four patients had GRC admixed with tumor. Two patients who demonstrated GRC but no neoplasm on final Mohs' sections had development of recurrent neoplasm after the initial procedure.

Conclusions.—
In the setting of suspected or proved cutaneous squamous cell carcinoma, GRC signifies the presence of viable neoplasm and warrants additional tissue resection.

(Arch Dermatol. 1992;128:649-652)

Author Affiliations
From the Departments of Dermatology (Drs Leshin and White), Otolaryngology (Dr Leshin), and Pathology (Drs Prichard and White), Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC.

Footnotes
Accepted for publication November 13, 1991.

Read before the Annual Meeting of the American College of Mohs Micrographic Surgery and Cutaneous Oncology, Orlando, Fla, March 12, 1991.

Reprint requests to Department of Dermatology, Bowman Gray School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157-1071 (Dr Leshin).

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