Supplementary Material for: Histologic Clearance of a Giant Cutaneous Squamous Cell Carcinoma with Imiquimod 5% Cream: A Case Report

INTRODUCTION

Cutaneous squamous cell carcinoma (cSCC) is one of the most common skin cancers, with an increasing incidence worldwide. Chronic sun exposure is a major risk factor and lesions are usually seen on sun-exposed areas such as the face, neck, scalp, and hands. Imiquimod cream, an immune response modifier, has shown promising results in the management of selected cases of cSCC.

CASE REPORT

A 70-year-old, Filipino male presented with 3-year history of a slow growing erythematous plaque on the abdomen. Physical examination revealed a solitary, well- defined, erythematous plaque measuring 5cm on the left lower quadrant of the abdomen. Histopathologic examination revealed cSCC. The patient declined surgery and opted for topical treatment with imiquimod 5% cream, applied over 24 weeks for a total of 104 applications. Serial biopsies taken at multiple follow-up points and anatomic sites confirmed complete histologic clearance.

CONCLUSION
This case highlights one of the few documented instances of histologic cure in a >5cm cSCC treated solely with imiquimod cream. It underscores the potential of imiquimod as a non-surgical alternative and expands current treatment for patients who may not be suitable candidates for conventional surgical excision.

引言
皮肤鳞状细胞癌（cutaneous squamous cell carcinoma, cSCC）是最常见的皮肤恶性肿瘤之一，全球发病率呈逐年上升态势。长期日光暴露是其主要致病危险因素，病灶多好发于面部、颈部、头皮及手部等日光暴露部位。咪喹莫特乳膏（imiquimod cream）作为一种免疫应答调节剂，在部分经筛选的cSCC患者治疗中已展现出可观的应用前景。

病例报告
1例70岁菲律宾男性患者，因腹部出现缓慢生长的红斑斑块病史达3年就诊。体格检查可见其腹部左下腹象限存在一处孤立、边界清晰的红斑斑块，直径约5cm。经组织病理学检查，确诊为皮肤鳞状细胞癌。该患者拒绝手术治疗，选择采用5%咪喹莫特乳膏进行局部治疗，持续给药24周，累计用药104次。在多次随访节点及不同解剖部位实施的系列活检结果证实，病灶已实现组织学完全清除。

结论
本病例为目前为数不多的、仅通过咪喹莫特乳膏单一疗法即可实现组织学治愈的直径＞5cm皮肤鳞状细胞癌病例之一。本案例凸显了咪喹莫特作为非手术治疗方案的潜力，可为不适于传统手术切除的患者拓展现有治疗选择。