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Squamous cell carcinoma of the esophagus (view source)

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#redirect [[Esophagus#Squamous_cell_carcinoma_of_the_esophagus]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Esophageal_squamous_cell_carcinoma_-_a1_--_high_mag.jpg
| Width      =
| Caption    = Esophageal squamous cell carcinoma. [[H&E stain]].
| Synonyms  =
| Micro      = atypical squamous cells invading into the lamina propria
| Subtypes  =
| LMDDx      = [[squamous dysplasia of the esophagus]]
| Stains    =
| IHC        = p63 +'ve, CK5/6 +'ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[esophagus]] - usually proximal or mid portion
| Assdx      = [[squamous dysplasia of the esophagus]], [[alcohol]], [[smoking]]
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  = dysphagia of solid and liquids
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = poor
| Other      =
| ClinDDx    = benign [[esophageal stricture]]
| Tx        = usu. surgery - if feasible, chemotherapy, radiation
}}
'''Squamous cell carcinoma of the esophagus''' is a relatively uncommon form of esophageal cancer.


It is also known as '''esophageal squamous cell carcinoma''', abbreviated '''esophageal SCC'''.
''Squamous cell carcinoma'', also ''squamous carcinoma'', is discussed in general terms in the ''[[squamous cell carcinoma]]'' article.
==General==
*Like squamous cell carcinoma elsewhere.
Risk factors:<ref name=Ref_APBR104>{{Ref APBR|104 Q1}}</ref>
*[[Ethanol abuse|Alcohol consumption]].
*[[Smoking|Tobacco use]].
*Food with nitrosamines.
*Burning-hot beverages.
**Disputed.<ref>{{Cite journal  | last1 = Zamora-Ros | first1 = R. | last2 = Luján-Barroso | first2 = L. | last3 = Bueno-de-Mesquita | first3 = HB. | last4 = Dik | first4 = VK. | last5 = Boeing | first5 = H. | last6 = Steffen | first6 = A. | last7 = Tjønneland | first7 = A. | last8 = Olsen | first8 = A. | last9 = Bech | first9 = BH. | title = Tea and coffee consumption and risk of esophageal cancer: the European Prospective Investigation into Cancer and Nutrition (EPIC) study. | journal = Int J Cancer | volume =  | issue =  | pages =  | month = Feb | year = 2014 | doi = 10.1002/ijc.28789 | PMID = 24535727 }}</ref>
Note:
*Reflux is ''not'' a risk factor for esophageal SCC.
**It is a risk factor indirectly for [[esophageal adenocarcinoma]].
Clinical:
*Dysphagia of solid and liquids.
*Weight loss.
*Multimodal treatment - surgery, chemotherapy and radiation.<ref name=pmid24480403>{{Cite journal  | last1 = Bass | first1 = GA. | last2 = Furlong | first2 = H. | last3 = O'Sullivan | first3 = KE. | last4 = Hennessy | first4 = TP. | last5 = Walsh | first5 = TN. | title = Chemoradiotherapy, with adjuvant surgery for local control, confers a durable survival advantage in adenocarcinoma and squamous cell carcinoma of the oesophagus. | journal = Eur J Cancer | volume =  | issue =  | pages =  | month = Jan | year = 2014 | doi = 10.1016/j.ejca.2013.12.022 | PMID = 24480403 }}</ref>
==Gross==
*Mass in the esophagus - classically proximal or mid portion.
==Microscopic==
Features - atypical squamous cells with invasion through the basement membrane:
*Cytology:
**Nucleus - typical central.
***+/-Mitoses.
**Cytoplasm - "dense-appearing", typically eosinophilic (may be intensely eosinophilic).
*+/-Squamous whorls.
Note:
*Just to make things confusing, the ''Staging'' of early SCC differs from that of early adenocarcinoma!
DDx:
*Reactive changes.
*[[Squamous dysplasia of the esophagus]].
*[[Adenocarcinoma of the esophagus]].
*[[metastasis|Metastatic]] carcinoma.
===Images===
<gallery>
Image: Esophageal squamous cell carcinoma -- intermed mag.jpg | Esophageal SCC - intermed. mag.
Image: Esophageal squamous cell carcinoma -- high mag.jpg | Esophageal SCC - high mag.
Image: Esophageal squamous cell carcinoma -- very high mag.jpg | Esophageal SCC - very high mag.
</gallery>
<gallery>
Image: Esophageal squamous cell carcinoma - a1 -- high mag.jpg | Esophageal SCC - high mag.
Image: Esophageal squamous cell carcinoma - a2 -- high mag.jpg | Esophageal SCC - high mag.
Image: Esophageal squamous cell carcinoma - a3 -- high mag.jpg | Esophageal SCC - high mag.
Image: Esophageal squamous cell carcinoma - a1 -- very high mag.jpg | Esophageal SCC - very high mag.
</gallery>
www:
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544238/figure/fig08/ Carcinoma in situ (nih.gov)].<ref name=pmid23330004>{{Cite journal  | last1 = Terada | first1 = T. | title = A clinicopathologic study of esophageal 860 benign and malignant lesions in 910 cases of consecutive esophageal biopsies. | journal = Int J Clin Exp Pathol | volume = 6 | issue = 2 | pages = 191-8 | month =  | year = 2013 | doi =  | PMID = 23330004 }}</ref>
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544238/figure/fig09/ Squamous cell carcinoma of the esophagus (nih.gov)].
==Sign out==
<pre>
ESOPHAGUS, BIOPSY:
- INVASIVE SQUAMOUS CELL CARCINOMA, KERATINIZING, MODERATELY DIFFERENTIATED.
COMMENT:
Benign squamous epithelium at least partially overlies the invasive squamous
cell carcinoma; this may mask the true extent of the lesion on endoscopy.
</pre>
===Micro===
The sections show a squamous mucosa with focal moderate atypia of the squamous cells,
keratinization and easily identified mitotic figures. The atypical cells are partially
covered by benign squamous cells, and there is a very sharp transition between the cells
with atypia and those without. The atypical squamous cells extend into the subepithelial tissue in irregularly shaped nests and cords. A small amount of benign muscle is present.
==See also==
*[[Esophagus]].
*[[Squamous cell carcinoma]].
==References==
{{Reflist|2}}
[[Category:Esophagus]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]
Michael
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