How would you approach management of a large, fungating squamous cell carcinoma of the auricle if surgical management is not desired by the patient?
For a tumor this size and with cartilage invasion, I would recommend starting with induction cemiplimab to best response (generally 4-6 cycles), followed by consolidative RT, generally electrons. Prior to starting the immunotherapy, I would stage the neck with a contrast CT scan, as tumors of this s...
I recently approached an identical situation as suggested by Dr. @Dr. First Last. There was enormous response facilitating radiotherapy. By the end of the cemiplimab, he looked decades younger and had totally clear skin. He had minor radiation dermatitis, far less than I had anticipated.
At our center, after careful staging, we would consider enrollment in the Alpha Tau ReSTART trial. The tumor would have to be recurrent after some sort of previous treatment (surgery, radiation, immunotherapy, or other), and no larger than 7 cm. Squamous cell histology would be required. Treatment c...
For imaging, MRI would be better than CT for assessment of the primary skin cancer and its involvement of the cartilage and local extension into the subdermis; these cancers can track into the EAC and places where visual assessment and palpation lack sensitivity. For my patient, I had a baseline stu...