Pain as an atypical presentation of squamous cell carcinoma.

BACKGROUND

Cancer of the skin may be difficult to diagnose clinically if there are minimal skin findings on examination.

OBJECTIVE

To remind physicians that the symptoms of squamous cell carcinoma (SCC) may precede physical signs of the tumor.

METHODS

Perineural invasion of SCC was confirmed by histologic examination of surgical specimens.

RESULTS

We present two patients whose initial presentation of SCC was facial pain due to extensive perineural invasion. Their diagnoses were delayed until skin lesions eventually became evident months later.

CONCLUSION

Early detection can be lifesaving, thus emphasizing the importance of including skin cancer in the differential for facial pain or paresthesia.