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Journal of the American Academy of Dermatology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le vendredi 31 janvier 2020
Doi : 10.1016/j.jaad.2019.10.067
accepted : 30 October 2019
Detection of subclinical disease with baseline and surveillance imaging in high-risk cutaneous squamous cell carcinomas

Jacqueline M. Maher, BA a, Chrysalyne D. Schmults, MD, MSCE b, Fadi Murad, MPH b, Pritesh S. Karia, MPH c, Carol B. Benson, MD d, Emily Stamell Ruiz, MD, MPH b,
a New York Medical College, Valhalla, New York 
b Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts 
c Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 
d Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts 

Correspondence to: Emily Stamell Ruiz, MD, MPH, Department of Dermatology, Brigham and Women's Hospital, 1153 Centre Street, Ste 4J, Jamaica Plain, MA 02130.Department of DermatologyBrigham and Women's Hospital1153 Centre Street, Ste 4J, Jamaica PlainMA02130

There are limited studies on imaging for management of high-risk cutaneous squamous cell carcinoma (HRCSSC).


To evaluate the impact of baseline (ie, at diagnosis) and surveillance (ie, subsequent time points after diagnosis) imaging on management of HRCSCCs.


All primary CSSCs treated at Brigham and Women's Hospital Mohs Surgery Clinic and Dana-Farber Cancer Institute High-Risk Skin Cancer Clinic from January 1, 2017 through June 1, 2019, were reviewed to identify tumors that underwent baseline or surveillance imaging. Tumors that underwent imaging were reviewed to determine the impact of imaging on management and ability of imaging to identify subclinical disease.


Eighty-three patients underwent imaging for 87 primary HRCSCCs, of which 48 (58%) underwent surveillance imaging. A total of 146 (59%) abnormal results were obtained from 248 imaging studies. Management was altered by 42 (24%) studies. Imaging detected subclinical disease in 21% of cases studied. A majority (56%) of detections were not seen initially but rather during surveillance imaging in the 2 years after treatment.


Single institution retrospective design.


Imaging identifies subclinical disease in HRCSCC. Prospective studies are needed to determine best practices for screening and surveillance in HRCSCC.

The full text of this article is available in PDF format.

Key words : cutaneous squamous cell carcinoma, imaging, metastasis, poor outcomes, skin cancer

Abbreviations used : AJCC 8, BWH, CSCC, CT, DM, MRI, NM, PET

 Funding sources: Supported by a Cancer Epidemiology, Prevention, and Control Training Grant (NCI T32 CA009314 to Mr Karia).
 Conflicts of interest: None disclosed.
 IRB approval status: Approved by Partners Research Committee.
 Reprints not available from the authors.

© 2019  American Academy of Dermatology, Inc.@@#104156@@
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