Difference between revisions of "Squamous cell carcinoma of the skin"

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Squamous cell carcinoma of the skin (view source)

Revision as of 16:19, 7 June 2022

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| Micro      =
| Micro      =
| Subtypes  = many see ''[[squamous cell carcinoma]]''
| Subtypes  = many see ''[[squamous cell carcinoma]]''
| LMDDx      = [[inverted follicular keratosis]], [[Paget disease of the breast]], [[eccrine carcinoma]], [[atypical fibroxanthoma]], [[malignant melanoma]], [[leiomyosarcoma]], [[basal cell carcinoma]] (for ''[[basaloid squamous cell carcinoma]]'')   
| LMDDx      = [[inverted follicular keratosis]], [[Paget disease of the breast]], [[eccrine carcinoma]], [[atypical fibroxanthoma]], [[malignant melanoma]], [[leiomyosarcoma]], [[basal cell carcinoma]] (for ''[[basaloid squamous cell carcinoma]]''), [[porocarcinoma]], [[pseudoepitheliomatous hyperplasia]]  
| Stains    =
| Stains    =
| IHC        = CK5/6 +ve, p63 +ve, K903 +ve, Ber-EP4 -ve, S-100 -ve
| IHC        = CK5/6 +ve, p63 +ve, K903 +ve, [[Ber-EP4]] -ve, S-100 -ve
| EM        =
| EM        =
| Molecular  =
| Molecular  =
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| Gross      = scaly patch or nodule, +/-ulceration
| Gross      = scaly patch or nodule, +/-ulceration
| Grossing  =
| Grossing  =
| Staging    = [[Squamous_cell_carcinoma_of_the_skin#Staging|squamous cell carcinoma of the skin staging]]
| Site      = [[skin]] - usu. sun exposed areas
| Site      = [[skin]] - usu. sun exposed areas
| Assdx      = [[actinic keratosis]], [[solar elastosis]]
| Assdx      = [[actinic keratosis]], [[solar elastosis]]
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*[[Eccrine carcinoma]].
*[[Eccrine carcinoma]].
*[[Basal cell carcinoma]] for [[basaloid squamous cell carcinoma]].
*[[Basal cell carcinoma]] for [[basaloid squamous cell carcinoma]].
*[[Porocarcinoma]].
*[[Pseudoepitheliomatous hyperplasia]].
===Grading===
*G1 - well differentiated - easily recognizable as squamous, abundant keratinization.
*G2 - moderately differentiated - keratinization focal (typically limited to keratin pearls, individual cells or horn cysts).
*G3 - poorly differentiated - difficult to establish as squamous.
*G4 - undifferentiated or anaplastic.


====Images====
====Images====
<gallery>
<gallery>
Image: :SkinTumors-P9020701.jpg | SCC - anaplastic. (WC)
Image: SkinTumors-P9020701.jpg | SCC - anaplastic. (WC)
</gallery>
</gallery>


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Image:Bowen_disease_%283%29.jpg | Bowen disease - 3. (WC)
Image:Bowen_disease_%283%29.jpg | Bowen disease - 3. (WC)
</gallery>
</gallery>
==IHC==
==IHC==
Bowen's disease panel:
Bowen's disease panel:
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*CK7 -ve.
*CK7 -ve.
**Toker cells CK7 +ve.<ref name=pmid19601945>{{Cite journal  | last1 = Nofech-Mozes | first1 = S. | last2 = Hanna | first2 = W. | title = Toker cells revisited. | journal = Breast J | volume = 15 | issue = 4 | pages = 394-8 | month =  | year =  | doi = 10.1111/j.1524-4741.2009.00743.x | PMID = 19601945 }}</ref>
**Toker cells CK7 +ve.<ref name=pmid19601945>{{Cite journal  | last1 = Nofech-Mozes | first1 = S. | last2 = Hanna | first2 = W. | title = Toker cells revisited. | journal = Breast J | volume = 15 | issue = 4 | pages = 394-8 | month =  | year =  | doi = 10.1111/j.1524-4741.2009.00743.x | PMID = 19601945 }}</ref>
Others:
*[[Ber-EP4]] usually -ve.<ref name=pmid19187107>{{Cite journal  | last1 = Yu | first1 = L. | last2 = Galan | first2 = A. | last3 = McNiff | first3 = JM. | title = Caveats in BerEP4 staining to differentiate basal and squamous cell carcinoma. | journal = J Cutan Pathol | volume = 36 | issue = 10 | pages = 1074-176 | month = Oct | year = 2009 | doi = 10.1111/j.1600-0560.2008.01223.x | PMID = 19187107 }}</ref>
** Usually +ve in [[BCC]].
*EMA +ve (~83% +ve).<ref name=pmid27039776>{{cite journal |authors=Ramezani M, Mohamadzaheri E, Khazaei S, Najafi F, Vaisi-Raygani A, Rahbar M, Sadeghi M |title=Comparison of EMA,CEA, CD10 and Bcl-2 Biomarkers by Immunohistochemistry in Squamous Cell Carcinoma and Basal Cell Carcinoma of the Skin |journal=Asian Pac J Cancer Prev |volume=17 |issue=3 |pages=1379–83 |date=2016 |pmid=27039776 |doi=10.7314/apjcp.2016.17.3.1379 |url=}}</ref>
** Usually -ve in BCC.
==Staging==
===Tumour stage===
{| class="wikitable sortable"
!T stage
!Criteria
!Comment
|-
| T1
| <=2 cm ''and'' less than two high-risk factors
| see ''microscopic'' for list of high-risk factors
|-
| T2
| >2 cm and less than two high-risk factors ''or'' two or more high-risk factors
| see ''microscopic'' for list of high-risk factors
|-
| T3
| tumour into nearby bone - maxilla, mandible, orbit, temporal bone
| uncommonly seen by pathology
|-
| T4
| tumour into axial skeleton or appendicular skeleton or perineural invasion of skull base
| basically never seen by pathology
|}


==Sign-out==
==Sign-out==
===Invasive SCC===
===Invasive SCC - small===
<pre>Scalp Lesion, Excision:
- INVASIVE SQUAMOUS CELL CARCINOMA, well-differentiated.
-- Margins NEGATIVE for carcinoma in situ and NEGATIVE for malignancy.
--- Closest margin (deep margin): 4 mm.
-- Maximal tumour dimension: 1.2 cm.
-- NEGATIVE for lymphovascular invasion.
-- NEGATIVE for perineural invasion.
- Extensive solar elastosis.
</pre>
 
===Invasive SCC - large===
<pre>
Skin Lesion, Mid-Back, Excision:
- Invasive SQUAMOUS CELL CARCINOMA, moderately differentiated.
- Margins NEGATIVE for carcinoma in situ and NEGATIVE for malignancy.
-- Closest margin: > 10 mm.
-- TNM stage: pT2 pN0.
- Extensive solar elastosis.
- Two benign lymph nodes (0/2).
- Please see synoptic report.
</pre>
 
====Block letters====
<pre>
<pre>
SKIN, SITE, BIOPSY:  
SKIN, SITE, BIOPSY:  
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==See also==
==See also==
*[[Dermatologic neoplasms]].
*[[Dermatologic neoplasms]].
*[[Squamous cell carcinoma]].


==References==
==References==
Michael
49,006

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