Treatment and Prognosis

A BSCC is an aggressive, rapidly growing tumour characterised by an advanced stage at the time of diagnosis and a poor prognosis. Metastases to the regional lymph nodes have been reported in two-thirds of patients [19, 195, 277, 293], and distant metastases involving lungs, bone, skin and brain in 37-50% of patients [19, 195, 293].

It is generally believed that BSCCs are more aggressive than conventional SCCs [103, 108, 195, 372, 377]. However, some studies indicate that BSCCs exhibit behaviour similar to that of high-grade conventional SCCs of the head and neck [19, 134, 222, 376].

The treatment of choice is radical surgical excision and, because of early regional lymph node and distant visceral metastases, radical neck dissection and supplementary radio- and chemotherapy [21, 372, 375].

Iliii >1

Fig. 1.18. Adenoid squamous cell carcinoma. a Islands of squa- due to acantholysis of neoplastic cells. b Anastomosing spaces and mous cell carcinoma with pseudoglandular (adenoid) structures channels mimicking an angiosarcoma.

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