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Cutaneous Squamous Cell Carcinoma With Sclerosing Features: An Uncommon and Potentially Aggressive Variant

Ronen, Shira, MD*; Gru, Alejandro A., MD; Noland, Mary M., MD‡,§; Rowe, David M., MD†,§; Wick, Mark R., MD†,§

The American Journal of Dermatopathology: August 2018 - Volume 40 - Issue 8 - p 575–579
doi: 10.1097/DAD.0000000000001169
Original Study

Abstract: Sclerosing squamous cell carcinoma (SCC), also known as “desmoplastic” SCC, is a rare subtype of cutaneous malignancy. This variant is clinically significant because it is associated with an increased risk of local recurrence and metastasis. We herein present 16 examples of sclerotic SCC of the skin in 8 men and 3 women, with a median age of 66 years. The most common site of origin for this tumor is the skin of the head and neck, including the scalp (5 tumors in 2 different patients), forehead (3 cases), nasal ala (2 cases), neck (2 cases in the same patient), ear (2 cases), cheek (1 case), and chest (1 case). Microscopically, sclerosing SCCs are characterized by cellular cords, nests, and islands, as well as scattered single cells infiltrating densely desmoplastic and collagenized connective tissue. The differential diagnosis principally includes sclerosing basal cell carcinoma, microcystic adnexal carcinoma, and desmoplastic trichoepithelioma. The main goals of this study are to further characterize these lesions pathologically, and increase general awareness of this SCC subtype.

*Department of Pathology, Medical College of Wisconsin, Milwaukee, WI;

Department of Pathology, Section of Dermatopathology, University of Virginia Health System, Charlottesville, VA;

Department of Dermatology, University of Virginia Health System, Charlottesville, VA; and

§PRW Laboratories, Charlottesville, VA.

Correspondence: Mark R. Wick, MD, Room 3020, University of Virginia Hospital, 1215 Lee Street, Charlottesville, VA 22908-0214 (e-mail:

The authors declare no conflicts of interest.

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