Parotid metastases of cutaneous squamous cell carcinoma in renal transplant recipients: Case series and literature review.

Cutaneous squamous cell skin carcinoma (cSCC) is the most common skin cancer in renal transplant recipients (RTR). Metastatic potential of cSCC is significantly higher in RTR than in the general population. Parotid metastases (PM) of cSCC are rare, but their prognosis is poor. The present study aimed to investigate the frequency and characteristics of PM of cSCC in our renal transplant cohort. Among 1610 patients who received kidney allografts at our institution in the period from January 1999 to December 2019, 84 patients (5.2%) developed at least one cSCC. Three patients were identified to develop PM within 3 to 6 months after the occurrence of primary cSCC. All PM were discovered by clinical examination and in an advanced stage. Two of them died early after the diagnosis of PMs (after 4 months and 1 year, respectively). In conclusion, immunosuppression is one of the major risk factors for the development of cSCC and its metastases. It contributes to the poor survival of patients with PMs of the cSCC. Our experience emphasizes the need for the employment of the radiological tests in patients with primary high-risk cSCC to evaluate nonpalpable lymph node involvement.