Management of Cutaneous Squamous Cell Carcinoma in Organ Transplant Recipients

The lifelong immunosuppression required for maintenance of allograft function in organ transplant recipients (OTR) increases the risk of cutaneous malignancies in this population. Prolonged survival posttransplantation further permits the development of late dermatologic complications of iatrogenic immunosuppression, particularly skin cancer. Cutaneous squamous cell carcinoma (CSCC) is the most common posttransplant malignancy, and in OTR can present as multiple, aggressive, and rapidly metastasizing lesions that are challenging to manage. Due to the high morbidity and potential mortality of CSCC in OTR, close dermatologic surveillance and aggressive treatment are essential. This review will address the challenge of managing posttransplant CSCC in the OTR population with a summary of the current therapeutic strategies in this patient cohort. The management of metastatic CSCC remains challenging, despite promising results from chemotherapeutic agents and novel targeted molecular inhibitors combined with radiation therapy. Ultimately, therapeutic considerations for CSCC in OTR should be determined in a multidisciplinary setting including the dermatologist, the transplant team, and appropriate specialists.