Desmoplasia is the formation of a densely collagenous stroma around a neoplasm. It occurs in a variety of malignancies including squamous cell carcinoma (SCC). While desmoplasia is uncommonly found in cutaneous SCC, it has been identified as an independent risk factor for local recurrence. We report a case series of desmoplastic SCC of the periorbital region.
Retrospective chart review.
Seven cases were identified: four of them male, median age 68. The mean follow-up was 48 months. In all cases the resulting defect after tumour excision was significantly larger than the estimated tumour size at presentation. 2 cases (29%) had aggressive local recurrence: one case required extensive salvage surgery including orbital exenteration and parotidectomy; the other case required repeat wide excision and adjuvant radiotherapy.
Desmoplastic SCC is a rare but highly aggressive variant that is infiltrative and locally aggressive. In the periocular region, it is potentially sight & life-threatening if it is not recognised & treated before orbital invasion occurs.