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Difference between revisions of "Anal squamous cell carcinoma"
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'''Anal squamous cell carcinoma''' is | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = Anus SquamousCellCarcinoma SCC NonKeratinizing AIA SCCIS CTR.jpg | |||
| Width = | |||
| Caption = Anal squamous cell carcinoma. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = | |||
| Subtypes = | |||
| LMDDx = [[anal intraepithelial neoplasia]], poorly differentiated [[rectal adenocarcinoma]], [[anal gland adenocarcinoma]] | |||
| Stains = | |||
| IHC = p16 +ve | |||
| EM = | |||
| Molecular = HPV +ve | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[anus]] | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = +/-men who have sex with men, +/-immunodeficiency or immunosuppression | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = most common anal cancer, overall uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = | |||
| Other = | |||
| ClinDDx = | |||
| Tx = surgical excision | |||
}} | |||
'''Anal squamous cell carcinoma''' is the most common type of [[anal cancer]].<ref name=pmid25741135>{{Cite journal | last1 = Ghosn | first1 = M. | last2 = Kourie | first2 = HR. | last3 = Abdayem | first3 = P. | last4 = Antoun | first4 = J. | last5 = Nasr | first5 = D. | title = Anal cancer treatment: Current status and future perspectives. | journal = World J Gastroenterol | volume = 21 | issue = 8 | pages = 2294-2302 | month = Feb | year = 2015 | doi = 10.3748/wjg.v21.i8.2294 | PMID = 25741135 }}</ref> | |||
It is also known as '''anal squamous carcinoma''' and '''squamous cell carcinoma of the anus'''. | It is also known as '''anal squamous carcinoma''' and '''squamous cell carcinoma of the anus'''. | ||
==General== | ==General== | ||
*Most common form of anal cancer. | *Most common form of anal cancer.<ref name=pmid25741135/> | ||
*Overall anal cancer uncommon.<ref name=pmid25741135/> | |||
*Strong association with [[HPV]].<ref name=pmid23616200>{{Cite journal | last1 = Cornall | first1 = AM. | last2 = Roberts | first2 = JM. | last3 = Garland | first3 = SM. | last4 = Hillman | first4 = RJ. | last5 = Grulich | first5 = AE. | last6 = Tabrizi | first6 = SN. | title = Anal and perianal squamous carcinomas and high-grade intraepithelial lesions exclusively associated with "low-risk" HPV genotypes 6 and 11. | journal = Int J Cancer | volume = 133 | issue = 9 | pages = 2253-8 | month = Nov | year = 2013 | doi = 10.1002/ijc.28228 | PMID = 23616200 }}</ref> | |||
Risk factors:<ref name=pmid23806153>{{Cite journal | last1 = Kutlubay | first1 = Z. | last2 = Engin | first2 = B. | last3 = Zara | first3 = T. | last4 = Tüzün | first4 = Y. | title = Anogenital malignancies and premalignancies: Facts and controversies. | journal = Clin Dermatol | volume = 31 | issue = 4 | pages = 362-73 | month = | year = | doi = 10.1016/j.clindermatol.2013.01.003 | PMID = 23806153 }}</ref> | Risk factors:<ref name=pmid23806153>{{Cite journal | last1 = Kutlubay | first1 = Z. | last2 = Engin | first2 = B. | last3 = Zara | first3 = T. | last4 = Tüzün | first4 = Y. | title = Anogenital malignancies and premalignancies: Facts and controversies. | journal = Clin Dermatol | volume = 31 | issue = 4 | pages = 362-73 | month = | year = | doi = 10.1016/j.clindermatol.2013.01.003 | PMID = 23806153 }}</ref> | ||
| Line 10: | Line 43: | ||
*Immunosuppressed. | *Immunosuppressed. | ||
*[[HIV]] infection. | *[[HIV]] infection. | ||
==Microscopic== | ==Microscopic== | ||
Features: | Features: | ||
*See ''[[squamous cell carcinoma]]''. | *See ''[[squamous cell carcinoma]]''. | ||
DDx: | |||
*[[Anal intraepithelial neoplasia]]. | |||
*Rectal squamous cell carcinoma.<ref name=pmid17661147>{{Cite journal | last1 = Nahas | first1 = CS. | last2 = Shia | first2 = J. | last3 = Joseph | first3 = R. | last4 = Schrag | first4 = D. | last5 = Minsky | first5 = BD. | last6 = Weiser | first6 = MR. | last7 = Guillem | first7 = JG. | last8 = Paty | first8 = PB. | last9 = Klimstra | first9 = DS. | title = Squamous-cell carcinoma of the rectum: a rare but curable tumor. | journal = Dis Colon Rectum | volume = 50 | issue = 9 | pages = 1393-400 | month = Sep | year = 2007 | doi = 10.1007/s10350-007-0256-z | PMID = 17661147 }}</ref> | |||
*Poorly differentiated [[rectal adenocarcinoma]]. | |||
*[[Anal gland adenocarcinoma]]. | |||
===Images=== | |||
<gallery> | <gallery> | ||
Image:Anus SquamousCellCarcinoma SCC NonKeratinizing AIA SCCIS CTR.jpg|Anus Squamous Cell Carcinoma (Non Keratinizing) - (SKB) | Image:Anus SquamousCellCarcinoma SCC NonKeratinizing AIA SCCIS CTR.jpg|Anus Squamous Cell Carcinoma (Non Keratinizing) - (SKB) | ||
| Line 19: | Line 60: | ||
Image:Anus SquamousCellCarcinoma SCC NonKeratinizing MP4 CTR.jpg|Anus Squamous Cell Carcinoma (Non Keratinizing or shall we say poorly keratinizing as there are squamatized nests focally at high power) - (SKB) | Image:Anus SquamousCellCarcinoma SCC NonKeratinizing MP4 CTR.jpg|Anus Squamous Cell Carcinoma (Non Keratinizing or shall we say poorly keratinizing as there are squamatized nests focally at high power) - (SKB) | ||
</gallery> | </gallery> | ||
==IHC== | ==IHC== | ||
| Line 27: | Line 65: | ||
*CDX2 -ve/+ve. | *CDX2 -ve/+ve. | ||
**May be useful to differentiate from [[vulva]] and [[penis]].<ref name=pmid23105122>{{Cite journal | last1 = Gunia | first1 = S. | last2 = Koch | first2 = S. | last3 = May | first3 = M. | title = Is CDX2 immunostaining useful for delineating anorectal from penile/vulvar squamous cancer in the setting of squamous cell carcinoma with clinically unknown primary site presenting with histologically confirmed inguinal lymph node metastasis? | journal = J Clin Pathol | volume = 66 | issue = 2 | pages = 109-12 | month = Feb | year = 2013 | doi = 10.1136/jclinpath-2012-201138 | PMID = 23105122 }}</ref> | **May be useful to differentiate from [[vulva]] and [[penis]].<ref name=pmid23105122>{{Cite journal | last1 = Gunia | first1 = S. | last2 = Koch | first2 = S. | last3 = May | first3 = M. | title = Is CDX2 immunostaining useful for delineating anorectal from penile/vulvar squamous cancer in the setting of squamous cell carcinoma with clinically unknown primary site presenting with histologically confirmed inguinal lymph node metastasis? | journal = J Clin Pathol | volume = 66 | issue = 2 | pages = 109-12 | month = Feb | year = 2013 | doi = 10.1136/jclinpath-2012-201138 | PMID = 23105122 }}</ref> | ||
*PD-L1 +ve in ~40% of cases.<ref name=pmid34790403>{{cite journal |authors=Armstrong SA, Malley R, Wang H, Lenz HJ, Arguello D, El-Deiry WS, Xiu J, Gatalica Z, Hwang JJ, Philip PA, Shields AF, Marshall JL, Salem ME, Weinberg BA |title=Molecular characterization of squamous cell carcinoma of the anal canal |journal=J Gastrointest Oncol |volume=12 |issue=5 |pages=2423–2437 |date=October 2021 |pmid=34790403 |pmc=8576238 |doi=10.21037/jgo-20-610 |url=}}</ref> | |||
**PD-1 expressed in nearly 70% of tumours.<ref name=pmid34790403/> | |||
==Sign out== | ==Sign out== | ||
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- INVASIVE SQUAMOUS CELL CARCINOMA. | - INVASIVE SQUAMOUS CELL CARCINOMA. | ||
</pre> | </pre> | ||
Notes: | |||
*There is no CAP Cancer Protocol Template. | |||
*AJCC staging is based on size of the tumour.<ref>URL: [https://www.cancer.org/cancer/types/anal-cancer/detection-diagnosis-staging/staging.html https://www.cancer.org/cancer/types/anal-cancer/detection-diagnosis-staging/staging.html]. Accessed on: June 26, 2023.</ref> | |||
==See also== | ==See also== | ||