Photo Credit: sdigital

The following is a summary of “Radiologic Imaging Aids Management of High-risk Cutaneous Squamous Cell Carcinoma: A Retrospective Cohort Study,” published in the April 2025 issue of Journal of the American Academy of Dermatology by Wei et al. 

Due to limited data on its effectiveness, radiologic imaging was not routinely used to evaluate high-risk cSCC.  

Researchers conducted a retrospective study to determine the utilization of radiologic imaging and its impact on management in high-risk cSCC.  

They analyzed invasive cSCC cases at the Cleveland Clinic over 25 years. Patients with primary BWH stage T2a high, T2b, T3, and recurrent cSCC tumors were included and categorized into imaged (n=138) and non-imaged (n=256) cohorts.  

The results showed imaged tumors were more likely to be BWH T2b/T3, located on the head/neck/trunk, and were moderately/poorly differentiated, with a larger diameter, depth beyond fat, and perineural involvement (all P <0.001). Unexpected findings were noted in 49% of imaged tumors, with local invasion beyond expectations (23%) and nodal metastasis (18%) being the most common. Imaging altered clinical management in 47% of cases, often changing the surgical approach.  

Investigators concluded that in high-risk cSCC, radiologic imaging frequently revealed unforeseen local invasion and nodal metastasis, altering management in about half the cases, thus supporting its consideration, particularly of the local site and nodal basins, for improved staging and treatment planning. 

Source: jaad.org/article/S0190-9622(25)00622-X/abstract