Difference between revisions of "Squamous cell carcinoma of the urinary bladder"
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| LMDDx = [[metastatic]] squamous cell carcinoma (esp. [[squamous cell carcinoma of the uterine cervix]]), [[urothelial carcinoma]] with squamous differentiation, [[condyloma acuminatum]], [[squamous dysplasia]], [[keratinising squamous metaplasia of the urinary bladder]] | | LMDDx = [[metastatic]] squamous cell carcinoma (esp. [[squamous cell carcinoma of the uterine cervix]]), [[urothelial carcinoma]] with squamous differentiation, [[condyloma acuminatum]], [[squamous dysplasia]], [[keratinising squamous metaplasia of the urinary bladder]] | ||
| Stains = | | Stains = | ||
| IHC = p16 -ve/+ve | | IHC = p16 -ve/+ve, CK20 -ve, CK7 -ve, CK14 +ve, GATA3 -ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
| Line 20: | Line 20: | ||
| Clinicalhx = lived in areas with ''Schistosoma haematobium'' | | Clinicalhx = lived in areas with ''Schistosoma haematobium'' | ||
| Signs = | | Signs = | ||
| Symptoms = | | Symptoms = hematuria | ||
| Prevalence = very rare | | Prevalence = very rare | ||
| Bloodwork = | | Bloodwork = | ||
| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = | | Prognosis = similar to UCC of the bladder | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = other bladder tumours | ||
| Tx = | | Tx = cystectomy | ||
}} | }} | ||
'''Squamous cell carcinoma of the urinary bladder''', abbreviated '''SCC of the bladder''', is a rare [[cancer]] of the [[urinary bladder]]. | '''Squamous cell carcinoma of the urinary bladder''', abbreviated '''SCC of the bladder''', is a rare [[cancer]] of the [[urinary bladder]]. | ||
| Line 38: | Line 38: | ||
**Common in areas with ''S. haematobium''. | **Common in areas with ''S. haematobium''. | ||
**Uncommon in areas without ''S. haematobium''. | **Uncommon in areas without ''S. haematobium''. | ||
*Five year survival of SCC of the bladder is similar to UCC of the bladder.<ref name=pmid26199176 >{{Cite journal | last1 = Izard | first1 = JP. | last2 = Siemens | first2 = DR. | last3 = Mackillop | first3 = WJ. | last4 = Wei | first4 = X. | last5 = Leveridge | first5 = MJ. | last6 = Berman | first6 = DM. | last7 = Peng | first7 = Y. | last8 = Booth | first8 = CM. | title = Outcomes of squamous histology in bladder cancer: a population-based study. | journal = Urol Oncol | volume = 33 | issue = 10 | pages = 425.e7-13 | month = Oct | year = 2015 | doi = 10.1016/j.urolonc.2015.06.011 | PMID = 26199176 }}</ref> | |||
**Unadjusted five year survival of UCC, SCC and UCC with squamous differentiation is 34%, 33% and 28% respectively. | |||
===Subclassification=== | |||
Divided into two subtypes: <ref name=pmid27547458>{{Cite journal | last1 = Martin | first1 = JW. | last2 = Carballido | first2 = EM. | last3 = Ahmed | first3 = A. | last4 = Farhan | first4 = B. | last5 = Dutta | first5 = R. | last6 = Smith | first6 = C. | last7 = Youssef | first7 = RF. | title = Squamous cell carcinoma of the urinary bladder: Systematic review of clinical characteristics and therapeutic approaches. | journal = Arab J Urol | volume = 14 | issue = 3 | pages = 183-91 | month = Sep | year = 2016 | doi = 10.1016/j.aju.2016.07.001 | PMID = 27547458 }}</ref> | |||
*Bilharzial-associated SCC (BSCC) - not associated with bilharziasis (Schistosoma). | |||
*Non-bilharzial SCC (NBSCC). | |||
Characteristics of NBSCC:<ref name=pmid27547458/> | |||
*Prevalance ~2-5% of bladder tumours (in Western countries).<ref>URL: [https://www.myvmc.com/diseases/bladder-cancer-squamous-cell-carcinoma-of-the-bladder/ https://www.myvmc.com/diseases/bladder-cancer-squamous-cell-carcinoma-of-the-bladder/]. Accessed on: 14 February 2018.</ref> | |||
*Usually high-grade. | |||
*Typical patient 7th decade. | |||
**Fifth decade for BSCC | |||
*Present with hematuria without irritative bladder symptoms. | |||
*Risk factors: indwelling catheters, chronic inflammation/irritants. | |||
==Microscopic== | ==Microscopic== | ||
| Line 57: | Line 72: | ||
**Not definite for separating from cervix - but suggestive: cervix ~86% +ve, bladder ~37% +ve.<ref name=pmid20571342>{{Cite journal | last1 = Cioffi-Lavina | first1 = M. | last2 = Chapman-Fredricks | first2 = J. | last3 = Gomez-Fernandez | first3 = C. | last4 = Ganjei-Azar | first4 = P. | last5 = Manoharan | first5 = M. | last6 = Jorda | first6 = M. | title = P16 expression in squamous cell carcinomas of cervix and bladder. | journal = Appl Immunohistochem Mol Morphol | volume = 18 | issue = 4 | pages = 344-7 | month = Jul | year = 2010 | doi = 10.1097/PAI.0b013e3181d2bbd7 | PMID = 20571342 }}</ref> | **Not definite for separating from cervix - but suggestive: cervix ~86% +ve, bladder ~37% +ve.<ref name=pmid20571342>{{Cite journal | last1 = Cioffi-Lavina | first1 = M. | last2 = Chapman-Fredricks | first2 = J. | last3 = Gomez-Fernandez | first3 = C. | last4 = Ganjei-Azar | first4 = P. | last5 = Manoharan | first5 = M. | last6 = Jorda | first6 = M. | title = P16 expression in squamous cell carcinomas of cervix and bladder. | journal = Appl Immunohistochem Mol Morphol | volume = 18 | issue = 4 | pages = 344-7 | month = Jul | year = 2010 | doi = 10.1097/PAI.0b013e3181d2bbd7 | PMID = 20571342 }}</ref> | ||
*CK14 +ve.<ref name=pmid25643514>{{Cite journal | last1 = Hammam | first1 = O. | last2 = Wishahiz | first2 = M. | last3 = Khalil | first3 = H. | last4 = El Ganzouri | first4 = H. | last5 = Badawy | first5 = M. | last6 = Elkhquly | first6 = A. | last7 = Elesaily | first7 = K. | title = Expression of cytokeratin 7, 20, 14 in urothelial carcinoma and squamous cell carcinoma of the Egyprian urinary bladder cancer. | journal = J Egypt Soc Parasitol | volume = 44 | issue = 3 | pages = 733-40 | month = Dec | year = 2014 | doi = | PMID = 25643514 }}</ref> | *CK14 +ve.<ref name=pmid25643514>{{Cite journal | last1 = Hammam | first1 = O. | last2 = Wishahiz | first2 = M. | last3 = Khalil | first3 = H. | last4 = El Ganzouri | first4 = H. | last5 = Badawy | first5 = M. | last6 = Elkhquly | first6 = A. | last7 = Elesaily | first7 = K. | title = Expression of cytokeratin 7, 20, 14 in urothelial carcinoma and squamous cell carcinoma of the Egyprian urinary bladder cancer. | journal = J Egypt Soc Parasitol | volume = 44 | issue = 3 | pages = 733-40 | month = Dec | year = 2014 | doi = | PMID = 25643514 }}</ref> | ||
*CK7 -ve. | *CK7 -ve.<ref name=pmid25643514/> | ||
*CK20 -ve.<ref name=pmid25643514/> | |||
===UCC versus SCC=== | ===UCC versus SCC=== | ||
IHC may be of some use:<ref name=pmid22995333>{{Cite journal | last1 = Gulmann | first1 = C. | last2 = Paner | first2 = GP. | last3 = Parakh | first3 = RS. | last4 = Hansel | first4 = DE. | last5 = Shen | first5 = SS. | last6 = Ro | first6 = JY. | last7 = Annaiah | first7 = C. | last8 = Lopez-Beltran | first8 = A. | last9 = Rao | first9 = P. | title = Immunohistochemical profile to distinguish urothelial from squamous differentiation in carcinomas of urothelial tract. | journal = Hum Pathol | volume = 44 | issue = 2 | pages = 164-72 | month = Feb | year = 2013 | doi = 10.1016/j.humpath.2012.05.018 | PMID = 22995333 }}</ref> | IHC may be of some use as per Gulmann ''et al.'':<ref name=pmid22995333>{{Cite journal | last1 = Gulmann | first1 = C. | last2 = Paner | first2 = GP. | last3 = Parakh | first3 = RS. | last4 = Hansel | first4 = DE. | last5 = Shen | first5 = SS. | last6 = Ro | first6 = JY. | last7 = Annaiah | first7 = C. | last8 = Lopez-Beltran | first8 = A. | last9 = Rao | first9 = P. | title = Immunohistochemical profile to distinguish urothelial from squamous differentiation in carcinomas of urothelial tract. | journal = Hum Pathol | volume = 44 | issue = 2 | pages = 164-72 | month = Feb | year = 2013 | doi = 10.1016/j.humpath.2012.05.018 | PMID = 22995333 }}</ref> | ||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
! Immunostain | ! Immunostain | ||
| Line 85: | Line 101: | ||
| 8% (1/12) | | 8% (1/12) | ||
| 93% (14/15) | | 93% (14/15) | ||
|} | |||
An another study from Egypt looks at CK7 and CK20 which is widely available:<ref name=pmid25643514>{{Cite journal | last1 = Hammam | first1 = O. | last2 = Wishahiz | first2 = M. | last3 = Khalil | first3 = H. | last4 = El Ganzouri | first4 = H. | last5 = Badawy | first5 = M. | last6 = Elkhquly | first6 = A. | last7 = Elesaily | first7 = K. | title = Expression of cytokeratin 7, 20, 14 in urothelial carcinoma and squamous cell carcinoma of the Egyprian urinary bladder cancer. | journal = J Egypt Soc Parasitol | volume = 44 | issue = 3 | pages = 733-40 | month = Dec | year = 2014 | doi = | PMID = 25643514 }}</ref> | |||
{| class="wikitable sortable" | |||
! Immunostain | |||
! SCC | |||
! UCC | |||
|- | |||
| CK7 | |||
| 0% (0/50) | |||
| 80% (120/150) | |||
|- | |||
| CK20 | |||
| 0% (0/50) | |||
| 70% (105/120) | |||
|} | |} | ||
Latest revision as of 16:50, 14 February 2018
| Squamous cell carcinoma of the urinary bladder | |
|---|---|
| Diagnosis in short | |
| LM DDx | metastatic squamous cell carcinoma (esp. squamous cell carcinoma of the uterine cervix), urothelial carcinoma with squamous differentiation, condyloma acuminatum, squamous dysplasia, keratinising squamous metaplasia of the urinary bladder |
| IHC | p16 -ve/+ve, CK20 -ve, CK7 -ve, CK14 +ve, GATA3 -ve |
| Site | urinary bladder |
|
| |
| Clinical history | lived in areas with Schistosoma haematobium |
| Symptoms | hematuria |
| Prevalence | very rare |
| Prognosis | similar to UCC of the bladder |
| Clin. DDx | other bladder tumours |
| Treatment | cystectomy |
Squamous cell carcinoma of the urinary bladder, abbreviated SCC of the bladder, is a rare cancer of the urinary bladder.
Squamous differentiation in urothelial carcinoma is common and much more frequent than SCC of the bladder.
General
- Strong association with Schistosoma haematobium.[1]
- Common in areas with S. haematobium.
- Uncommon in areas without S. haematobium.
- Five year survival of SCC of the bladder is similar to UCC of the bladder.[2]
- Unadjusted five year survival of UCC, SCC and UCC with squamous differentiation is 34%, 33% and 28% respectively.
Subclassification
Divided into two subtypes: [3]
- Bilharzial-associated SCC (BSCC) - not associated with bilharziasis (Schistosoma).
- Non-bilharzial SCC (NBSCC).
Characteristics of NBSCC:[3]
- Prevalance ~2-5% of bladder tumours (in Western countries).[4]
- Usually high-grade.
- Typical patient 7th decade.
- Fifth decade for BSCC
- Present with hematuria without irritative bladder symptoms.
- Risk factors: indwelling catheters, chronic inflammation/irritants.
Microscopic
Features:
- See squamous cell carcinoma article.
DDx:
- Metastatic squamous cell carcinoma.
- Urothelial carcinoma with squamous differentiation - very common.
- In biopsies, this should be mentioned as a possibility.
- Condyloma acuminatum.
- Squamous dysplasia.
- Keratinising squamous metaplasia of the urinary bladder.
IHC
Features:
- p16 -ve/+ve.
- Not definite for separating from cervix - but suggestive: cervix ~86% +ve, bladder ~37% +ve.[5]
- CK14 +ve.[6]
- CK7 -ve.[6]
- CK20 -ve.[6]
UCC versus SCC
IHC may be of some use as per Gulmann et al.:[7]
| Immunostain | Pure SCC (12 cases) | Pure UCC (15 cases) |
|---|---|---|
| CK14 | 100% (12/12) | 27% (4/15) |
| Desmoglein-3 | 75% (9/12) | 0% (0/15) |
| GATA3 | 0% (0/12) | 93% (14/15) |
| Uroplakin III | 0% (0/12) | 67% (10/15) |
| S100P | 8% (1/12) | 93% (14/15) |
An another study from Egypt looks at CK7 and CK20 which is widely available:[6]
| Immunostain | SCC | UCC |
|---|---|---|
| CK7 | 0% (0/50) | 80% (120/150) |
| CK20 | 0% (0/50) | 70% (105/120) |
Sign out
In areas not endemic for S. haematobium, reports of biopsies should raise the possibility of UCC with squamous differentiation and metastasis.
See also
References
- ↑ Michaud, DS.. "Chronic inflammation and bladder cancer.". Urol Oncol 25 (3): 260-8. doi:10.1016/j.urolonc.2006.10.002. PMID 17483025.
- ↑ Izard, JP.; Siemens, DR.; Mackillop, WJ.; Wei, X.; Leveridge, MJ.; Berman, DM.; Peng, Y.; Booth, CM. (Oct 2015). "Outcomes of squamous histology in bladder cancer: a population-based study.". Urol Oncol 33 (10): 425.e7-13. doi:10.1016/j.urolonc.2015.06.011. PMID 26199176.
- ↑ 3.0 3.1 Martin, JW.; Carballido, EM.; Ahmed, A.; Farhan, B.; Dutta, R.; Smith, C.; Youssef, RF. (Sep 2016). "Squamous cell carcinoma of the urinary bladder: Systematic review of clinical characteristics and therapeutic approaches.". Arab J Urol 14 (3): 183-91. doi:10.1016/j.aju.2016.07.001. PMID 27547458.
- ↑ URL: https://www.myvmc.com/diseases/bladder-cancer-squamous-cell-carcinoma-of-the-bladder/. Accessed on: 14 February 2018.
- ↑ Cioffi-Lavina, M.; Chapman-Fredricks, J.; Gomez-Fernandez, C.; Ganjei-Azar, P.; Manoharan, M.; Jorda, M. (Jul 2010). "P16 expression in squamous cell carcinomas of cervix and bladder.". Appl Immunohistochem Mol Morphol 18 (4): 344-7. doi:10.1097/PAI.0b013e3181d2bbd7. PMID 20571342.
- ↑ 6.0 6.1 6.2 6.3 Hammam, O.; Wishahiz, M.; Khalil, H.; El Ganzouri, H.; Badawy, M.; Elkhquly, A.; Elesaily, K. (Dec 2014). "Expression of cytokeratin 7, 20, 14 in urothelial carcinoma and squamous cell carcinoma of the Egyprian urinary bladder cancer.". J Egypt Soc Parasitol 44 (3): 733-40. PMID 25643514.
- ↑ Gulmann, C.; Paner, GP.; Parakh, RS.; Hansel, DE.; Shen, SS.; Ro, JY.; Annaiah, C.; Lopez-Beltran, A. et al. (Feb 2013). "Immunohistochemical profile to distinguish urothelial from squamous differentiation in carcinomas of urothelial tract.". Hum Pathol 44 (2): 164-72. doi:10.1016/j.humpath.2012.05.018. PMID 22995333.