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In Germany, which has a nationwide skin cancer screening program, cSCC is usually detected in early tumor stages and can curatively be treated by surgical excision. We report the case of a 59-year-old man who had a giant untreated cSCC of the scalp and died from the local and systemic effects of the aggressively growing tumor. A subsequent medicolegal autopsy was performed. It is noteworthy that the patient had refused medical therapy throughout his lifetime despite the prominence of the tumor. Embarrassment, fear of stigmatization, and denial of the disease itself, as a coping mechanism for self-protection, are possible explanations for giant tumors not being treated, leading to a heightened importance of psycho-oncology in modern cancer therapy to ensure that the mental health of the patient remains intact.<\/jats:p>","DOI":"10.1007\/s12024-026-01194-w","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T08:58:39Z","timestamp":1771664319000},"page":"739-742","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lethal medical course of an untreated giant cutaneous squamous cell carcinoma"],"prefix":"10.1007","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7527-292X","authenticated-orcid":false,"given":"Johanna","family":"Hertzberg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Kleemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel A.","family":"Verhoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannes","family":"Gruber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,21]]},"reference":[{"key":"1194_CR1","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.1016\/j.ejca.2015.06.110","volume":"51","author":"A Stratigos","year":"2015","unstructured":"Stratigos A, Garbe C, Lebbe C, Malvehy J, del Marmol V, Pehamberger H, et al. Diagnosis and treatment of invasive squamous cell carcinoma of the skin: European consensus-based interdisciplinary guideline. Eur J Cancer. 2015;51:1989\u20132007. https:\/\/doi.org\/10.1016\/j.ejca.2015.06.110.","journal-title":"Eur J Cancer"},{"key":"1194_CR2","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1007\/s00761-007-1301-1","volume":"14","author":"C Garbe","year":"2008","unstructured":"Garbe C. Fr\u00fcherkennung und Prim\u00e4rpr\u00e4vention von Hautkrebs. Onkologe. 2008;14:156\u201363. https:\/\/doi.org\/10.1007\/s00761-007-1301-1.","journal-title":"Onkologe"},{"key":"1194_CR3","doi-asserted-by":"publisher","first-page":"1152","DOI":"10.1007\/s00105-003-0646-7","volume":"54","author":"R Greinert","year":"2003","unstructured":"Greinert R, Volkmer B, Wende A, Voss S, Breitbart EW. Pr\u00e4vention von HautkrebsNotwendigkeit, Durchf\u00fchrung und Erfolg. [Prevention of skin cancer. Necessity, implementation and success]. 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J Dtsch Dermatol Ges. 2020;18:400\u201313. https:\/\/doi.org\/10.1111\/ddg.14072.","journal-title":"J Dtsch Dermatol Ges"},{"key":"1194_CR6","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/S1470-2045(19)30728-4","volume":"21","author":"MR Migden","year":"2020","unstructured":"Migden MR, Khushalani NI, Chang ALS, Lewis KD, Schmults CD, Hernandez-Aya L, et al. Cemiplimab in locally advanced cutaneous squamous cell carcinoma: results from an open-label, phase 2, single-arm trial. Lancet Oncol. 2020;21:294\u2013305. https:\/\/doi.org\/10.1016\/S1470-2045(19)30728-4.","journal-title":"Lancet Oncol"},{"key":"1194_CR7","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2020-000775","author":"D Rischin","year":"2020","unstructured":"Rischin D, Migden MR, Lim AM, Schmults CD, Khushalani NI, Hughes BGM, et al. Phase 2 study of cemiplimab in patients with metastatic cutaneous squamous cell carcinoma: primary analysis of fixed-dosing, long-term outcome of weight-based dosing. 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