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Jennifer Z. Cooper, MD; Marc D. Brown, MD

Arch Dermatol. 2006;142:755-758.

Background  Several risk factors are generally accepted to portend more aggressive behavior of cutaneous squamous cell carcinoma. These include tumor size, tumor depth, histologic subtype, location on the lip or ear, tumor arising in scar, recurrent tumor, and tumor demonstrating perineural invasion. Organ transplant recipients can have significant morbidity and mortality from squamous cell carcinoma.

Observations  Four organ transplant recipients developed metastatic disease from squamous cell carcinoma of the scalp.

Conclusions  Squamous cell carcinoma of the scalp in organ transplant recipients should be considered a high-risk tumor because of its anatomic location. Margin-controlled tumor extirpation, sentinel lymph node biopsy, and adjuvant radiation therapy should all be considered in the organ transplant recipient population.

Author Affiliations: Departments of Dermatology, University of Maryland, Baltimore (Dr Cooper), and University of Rochester Medical Center, Rochester, NY (Dr Brown).

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