Squamous cell carcinoma of the urinary bladder
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| 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) |
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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.