Metastases from squamous cell carcinoma of the skin and lip. An analysis of twenty-seven cases.

Of 365 consecutive squamous cell carcinomas treated by Mohs surgery, 27 (7.4%) later metastasized. Tumors of the temple, the dorsa of the hands, and the lips were more likely to metastasize than tumors located elsewhere. None of the metastatic lesions developed in antecedent inflammatory or degenerative conditions. No single factor was useful in predicting metastasis, but metastatic lesions, on average, were significantly larger and deeper than nonmetastatic lesions. It was much more difficult to control the primary lesion of patients with metastases. Five of the 27 patients died of metastatic disease despite aggressive surgery, radiation therapy, or both.