Anal squamous cell carcinoma

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Anal squamous cell carcinoma is the most common type of anal cancer.[1]

Anal squamous cell carcinoma
Diagnosis in short

Anal squamous cell carcinoma. H&E stain.
LM DDx anal intraepithelial neoplasia, poorly differentiated rectal adenocarcinoma, anal gland adenocarcinoma
IHC p16 +ve
Molecular HPV +ve
Site anus
Clinical history +/-men who have sex with men, +/-immunodeficiency or immunosuppression
Prevalence most common anal cancer, overall uncommon
Treatment surgical excision

It is also known as anal squamous carcinoma and squamous cell carcinoma of the anus.

General

  • Most common form of anal cancer.[1]
  • Overall anal cancer uncommon.[1]
  • Strong association with HPV.[2]

Risk factors:[3]

  • Men who have sex with men.
  • Immunosuppressed.
  • HIV infection.

Microscopic

Features:

DDx:

Images

  • Anus Squamous Cell Carcinoma (Non Keratinizing) - (SKB)

  • Anus Squamous Cell Carcinoma (Non Keratinizing) - (SKB)

  • Anus Squamous Cell Carcinoma (Non Keratinizing or shall we say poorly keratinizing as there are squamatized nests focally at high power) - (SKB)

IHC

  • p16 +ve.[5]
  • CDX2 -ve/+ve.
  • PD-L1 +ve in ~40% of cases.[6]
    • PD-1 expressed in nearly 70% of tumours.[6]

Sign out

RECTUM, DISTAL, BIOPSY:
- INVASIVE SQUAMOUS CELL CARCINOMA.

Notes:

  • There is no CAP Cancer Protocol Template.
  • AJCC staging is based on size of the tumour.[7]

See also

References

  1. ↑ 1.0 1.1 1.2 Ghosn, M.; Kourie, HR.; Abdayem, P.; Antoun, J.; Nasr, D. (Feb 2015). "Anal cancer treatment: Current status and future perspectives.". World J Gastroenterol 21 (8): 2294-2302. doi:10.3748/wjg.v21.i8.2294. PMID 25741135.
  2. ↑ Cornall, AM.; Roberts, JM.; Garland, SM.; Hillman, RJ.; Grulich, AE.; Tabrizi, SN. (Nov 2013). "Anal and perianal squamous carcinomas and high-grade intraepithelial lesions exclusively associated with "low-risk" HPV genotypes 6 and 11.". Int J Cancer 133 (9): 2253-8. doi:10.1002/ijc.28228. PMID 23616200.
  3. ↑ Kutlubay, Z.; Engin, B.; Zara, T.; Tüzün, Y.. "Anogenital malignancies and premalignancies: Facts and controversies.". Clin Dermatol 31 (4): 362-73. doi:10.1016/j.clindermatol.2013.01.003. PMID 23806153.
  4. ↑ Nahas, CS.; Shia, J.; Joseph, R.; Schrag, D.; Minsky, BD.; Weiser, MR.; Guillem, JG.; Paty, PB. et al. (Sep 2007). "Squamous-cell carcinoma of the rectum: a rare but curable tumor.". Dis Colon Rectum 50 (9): 1393-400. doi:10.1007/s10350-007-0256-z. PMID 17661147.
  5. ↑ 5.0 5.1 Gunia, S.; Koch, S.; May, M. (Feb 2013). "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?". J Clin Pathol 66 (2): 109-12. doi:10.1136/jclinpath-2012-201138. PMID 23105122.
  6. ↑ 6.0 6.1 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 (October 2021). "Molecular characterization of squamous cell carcinoma of the anal canal". J Gastrointest Oncol 12 (5): 2423–2437. doi:10.21037/jgo-20-610. PMC 8576238. PMID 34790403. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8576238/.
  7. ↑ URL: https://www.cancer.org/cancer/types/anal-cancer/detection-diagnosis-staging/staging.html. Accessed on: June 26, 2023.
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