Spinal Carcinoma (Squamous Cell Carcinoma) – Specialists and Information

Just as with malignant melanoma, UV exposure from sunlight plays a decisive role in the development of spinalioma. Sun exposure over several years can alter the genetic material (DNA) in skin cells in such a way that they become cancerous. In many cases, the tumor develops from a precancerous lesion.

Actinic keratosis appears as a sharply defined red patch with a sandpaper-like surface texture. Although it is not malignant in itself, you should still have it treated due to the risk of malignant transformation. In rare cases, a spinalioma can also develop from chronic wounds, burn scars, or other skin conditions.

Similarly, carcinogenic substances such as arsenic and X-rays or gamma rays can promote the development of a spinalioma. Human papillomaviruses (HPV) are also suspected of increasing the risk of cancer. Squamous cell carcinoma of the lip is a condition that occurs most frequently in pipe smokers and glassblowers.

People with a weakened immune system generally have an increased risk of developing spinalioma. For example, patients with HIV infections or people taking immunosuppressive medications are more likely to develop the disease. They also tend to have a more unfavorable course of the disease.

In its early stages, squamous cell carcinoma resembles actinic keratosis. It therefore appears as reddened patches with slight scaling. As the disease progresses, the tumor grows in a nodular manner, accompanied by scaling and crusting. 

Squamous cell carcinoma of the skin (also known as spinalioma or squamous cell carcinoma) is the second most common malignant skin tumor @ Luis /AdobeStock

The firmly attached keratinized areas of the tumor cannot be removed and may bleed if one attempts to peel them off. Scaly carcinoma causes little or no pain. However, as it grows, it can invade the surrounding tissue and destroy the structures there. Scaly carcinoma tends to grow rather slowly. At times, the symptoms appear to improve or even disappear completely.

Unlike malignant melanoma, spinalioma rarely metastasizes. Squamous cell carcinomas of the skin metastasize in only three to five percent of all cases. Tumors of the mucous membranes and transitional epithelium, on the other hand, are more aggressive and have a higher rate of metastasis. Typically, the lymph nodes are affected first, followed later by other organs.

A dermatologist can quickly identify the typical skin changes as spinalioma. To confirm the diagnosis, the doctor takes a tissue sample from the tumor (biopsy) and has it examined in a laboratory.

To distinguish squamous cell carcinoma from other skin tumors, experts use immunohistochemical techniques.

To rule out metastasis, the doctor palpates the surrounding lymph nodes and performs an ultrasound examination. The doctor can detect distant metastases in other organs using X-rays or computed tomography.

Various treatment methods can be used to treat spinalioma.

These include:

• Surgery
• Radiation therapy
• Chemotherapy
• Immunotherapy

The standard treatment is complete surgical removal of the tumor. If the lymph nodes are also affected, they are removed as well. If surgery is not possible, doctors can freeze the tumor or treat it using photodynamic therapy. In this procedure, certain processes generate toxic substances that damage the tumor. Local chemotherapy and immunotherapy are also among the treatment options.

In advanced stages or when metastases are present in other organs, doctors treat spinalioma with systemic chemotherapy. In this treatment, patients receive substances that inhibit cell growth and cell division throughout the body. 

After successful treatment, patients must attend follow-up appointments every three to six months. This is important for detecting potential metastases or relapses at an early stage. Those affected should avoid UV light as much as possible, check their skin regularly, and consult a dermatologist immediately if they notice any abnormalities.

The prognosis for this malignant tumor depends primarily on the location and size of the tumor. The depth of invasion, the histological structure of the tumor, and the presence of any treatment that weakens the immune system also influence the course of the disease. 

Squamous cell carcinomas smaller than two centimeters in diameter rarely metastasize and therefore have a good prognosis. They can be treated with surgery and chemotherapy. However, since they often recur, a complete cure is not possible in most cases.

The presence of metastases and delayed treatment significantly worsen the prognosis. Overall, the mortality rate is relatively low. The 5-year survival rate is 70 percent. This means that five years after diagnosis, approximately 70% of all spinalioma patients are still alive.