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This article deal with '''squamous cell carcinoma''', also '''squamous carcinoma''', a very common epithelial derived malignant neoplasm that can arise from many sites. It is commonly abbreviated '''SCC'''. | [[Image:Esophageal_squamous_cell_carcinoma_-_a1_--_high_mag.jpg| thumb| Squamous cell carcinoma. [[H&E stain]]. (WC)]] | ||
This article deal with '''squamous cell carcinoma''', also '''squamous carcinoma''', a very common epithelial derived malignant neoplasm that can arise from many sites. It is commonly abbreviated '''[[SCC]]'''. | |||
=Sites= | =Sites= | ||
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===Head and neck=== | ===Head and neck=== | ||
{{Main|Squamous cell carcinoma of the head and neck}} | |||
*Most common tumour of the [[head and neck pathology|head & neck]]. | *Most common tumour of the [[head and neck pathology|head & neck]]. | ||
**[[Tongue squamous cell carcinoma]] is dealt with separately. | |||
*''[[Nasopharyngeal carcinoma]]'' can be considered a variant SCC. | |||
*HPV-associated SCC is dealt with in ''[[HPV-associated head and neck squamous cell carcinoma]]''. | |||
====Tumour extent==== | ====Tumour extent==== | ||
*There is no agreed upon measure tumour extent (tumour thickness/depth of invasion)<ref name=pmid16240329>{{Cite journal | last1 = Pentenero | first1 = M. | last2 = Gandolfo | first2 = S. | last3 = Carrozzo | first3 = M. | title = Importance of tumor thickness and depth of invasion in nodal involvement and prognosis of oral squamous cell carcinoma: a review of the literature. | journal = Head Neck | volume = 27 | issue = 12 | pages = 1080-91 | month = Dec | year = 2005 | doi = 10.1002/hed.20275 | PMID = 16240329 }}</ref> - proposed measures:<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/LipOralCav_11protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/LipOralCav_11protocol.pdf]. Accessed on: 3 April 2012.</ref> | *There is no agreed upon measure of tumour extent (tumour thickness/depth of invasion)<ref name=pmid16240329>{{Cite journal | last1 = Pentenero | first1 = M. | last2 = Gandolfo | first2 = S. | last3 = Carrozzo | first3 = M. | title = Importance of tumor thickness and depth of invasion in nodal involvement and prognosis of oral squamous cell carcinoma: a review of the literature. | journal = Head Neck | volume = 27 | issue = 12 | pages = 1080-91 | month = Dec | year = 2005 | doi = 10.1002/hed.20275 | PMID = 16240329 }}</ref> - proposed measures:<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/LipOralCav_11protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/LipOralCav_11protocol.pdf]. Accessed on: 3 April 2012.</ref> | ||
**"Tumour thickness" = perpendicular distance from mucosal surface to deepest point of invasion. | **"Tumour thickness" = perpendicular distance from mucosal surface to deepest point of invasion. | ||
**"Tumour depth" = perpendicular distance epithelial basement membrane to deepest point of invasion. | **"Tumour depth" = perpendicular distance from epithelial basement membrane to deepest point of invasion. | ||
===Uterine cervix=== | ===Uterine cervix=== | ||
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{{Main|Squamous cell carcinoma of the esophagus}} | {{Main|Squamous cell carcinoma of the esophagus}} | ||
*Upper and middle esophagus. | *Upper and middle esophagus. | ||
===Anus=== | |||
{{Main|Anal squamous cell carcinoma}} | |||
*Most common form of anal cancer. | |||
===Other sites=== | ===Other sites=== | ||
*[[Colorectal carcinoma|Colorectum]]. | *[[Colorectal carcinoma|Colorectum]]. | ||
*[[Squamous cell carcinoma of the penis]]. | |||
*[[Squamous cell carcinoma of the urinary bladder]]. | |||
=Microscopic= | =Microscopic= | ||
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**Good prognosis. | **Good prognosis. | ||
**EBV association. | **EBV association. | ||
<gallery> | |||
Image:Anus SquamousCellCarcinoma SCC NonKeratinizing AIA SCCIS CTR.jpg |Anus Squamous Cell Carcinoma (Non Keratinizing)-(SKB) | |||
Image:Anus SquamousCellCarcinoma SCC NonKeratinizing MP4 CTR.jpg|Anus Squamous Cell Carcinoma (Non Keratinizing) -(SKB) | |||
Image:Anus SquamousCellCarcinoma SCC NonKeratinizing MP CTR.jpg|Anus Squamous Cell Carcinoma (Non Keratinizing) - (SKB) | |||
</gallery> | |||
Features based on classification:<ref name=Ref_Sternberg4_975>{{Ref Sternberg4|975}}</ref> | Features based on classification:<ref name=Ref_Sternberg4_975>{{Ref Sternberg4|975}}</ref> | ||
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=Subtypes= | =Subtypes= | ||
There are several subtypes:<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/LipOralCav_11protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/LipOralCav_11protocol.pdf]. Accessed on: 3 April 2012.</ref> | There are several subtypes:<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/LipOralCav_11protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/LipOralCav_11protocol.pdf]. Accessed on: 3 April 2012.</ref> | ||
*Adenosquamous carcinoma. | *[[Adenosquamous carcinoma]]. | ||
*Ancatholytic squamous cell carcinoma. | *Ancatholytic squamous cell carcinoma. | ||
*Basaloid squamous cell carcinoma - poor prognosis, usu. diagnosed by recognition of typical SCC. | *[[Basaloid squamous cell carcinoma]] - poor prognosis, usu. diagnosed by recognition of typical SCC. | ||
*Carcinoma cuniculatum. | *Carcinoma cuniculatum. | ||
*Verrucous carcinoma - good prognosis, rare. | *Verrucous carcinoma - good prognosis, rare. | ||
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*Lymphoepithelial carcinoma - rare. | *Lymphoepithelial carcinoma - rare. | ||
*Spindle cell squamous carcinoma - a common spindle cell lesion of the H&N. | *Spindle cell squamous carcinoma - a common spindle cell lesion of the H&N. | ||
==Carcinoma cuniculatum== | |||
===General=== | |||
*Rare. | |||
*Good prognosis.<ref name=pmid19625845>{{Cite journal | last1 = Kruse | first1 = AL. | last2 = Graetz | first2 = KW. | title = Carcinoma cuniculatum: a rare entity in the oral cavity. | journal = J Craniofac Surg | volume = 20 | issue = 4 | pages = 1270-2 | month = Jul | year = 2009 | doi = 10.1097/SCS.0b013e3181ace06b | PMID = 19625845 }}</ref> | |||
===Gross=== | |||
*Usually lower extremities. | |||
**Classically plantar aspect of foot.<ref name=pmid19625845/> | |||
===Microscopic=== | |||
Features: | |||
*Nests squamous epithelium with minimal atypia in the dermis - '''key feature'''. | |||
*Hyperkeratosis. | |||
*Parakeratosis. | |||
*Acanthosis. | |||
Image: | |||
*[http://www.cmaj.ca/content/177/3/249.2/F2.expansion.html Carcinoma cuniculatum (cmaj.ca)]. | |||
==Verrucous squamous cell carcinoma== | ==Verrucous squamous cell carcinoma== | ||
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*Good prognosis. | *Good prognosis. | ||
*Histomorphologically deceptively bland, i.e. non-malignant appearing. | *Histomorphologically deceptively bland, i.e. non-malignant appearing. | ||
*Wart-like (verruca = [[wart]]). | |||
*The clinical history, e.g. ''huge verrucous cancer'', is often important for making the diagnosis. | |||
===Microscopic=== | ===Microscopic=== | ||
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DDx: | DDx: | ||
*[[Papilloma]]. | *[[Papilloma]]. | ||
*[[Wart]]. | |||
Images | ====Images==== | ||
*[http://www.juniordentist.com/wp-content/uploads/2011/06/Verrucous-carcinoma-histology.jpg Verrucous carcinoma (juniordentist.com)].<ref>URL: [http://www.juniordentist.com/verrucous-carcinoma.html http://www.juniordentist.com/verrucous-carcinoma.html]. Accessed on: 3 April 2012.</ref> | *[http://www.juniordentist.com/wp-content/uploads/2011/06/Verrucous-carcinoma-histology.jpg Verrucous carcinoma (juniordentist.com)].<ref>URL: [http://www.juniordentist.com/verrucous-carcinoma.html http://www.juniordentist.com/verrucous-carcinoma.html]. Accessed on: 3 April 2012.</ref> | ||
*[http://www.pathologyoutlines.com/images/prostate/psverrucous_scc_01.jpg Verrucous SCC (pathologyoutlines.com)]. | *[http://www.pathologyoutlines.com/images/prostate/psverrucous_scc_01.jpg Verrucous SCC (pathologyoutlines.com)]. | ||
==Spindle cell squamous carcinoma== | ==Spindle cell squamous carcinoma== | ||
*[[AKA]] ''sarcomatoid squamous cell carcinoma''.<ref name=pmid18787630 >{{Cite journal | last1 = Hall | first1 = JM. | last2 = Saenger | first2 = JS. | last3 = Fadare | first3 = O. | title = Diagnostic utility of P63 and CD10 in distinguishing cutaneous spindle cell/sarcomatoid squamous cell carcinomas and atypical fibroxanthomas. | journal = Int J Clin Exp Pathol | volume = 1 | issue = 6 | pages = 524-30 | month = Mar | year = 2008 | doi = | PMID = 18787630 }}</ref> | |||
===General=== | ===General=== | ||
*Common spindle cell lesion of the head and neck. | *Common spindle cell lesion of the head and neck. | ||
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*Spindle cell [[melanoma]]. | *Spindle cell [[melanoma]]. | ||
*Mesenchymal neoplasms - ''see [[spindle cell lesions]]''. | *Mesenchymal neoplasms - ''see [[spindle cell lesions]]''. | ||
====Images==== | |||
<gallery> | |||
Image:SkinTumors-P5300131.JPG | Spindle cell squamous carcinoma. (WC) | |||
</gallery> | |||
===IHC=== | ===IHC=== | ||
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===General=== | ===General=== | ||
*May mimic ''[[adenoid cystic carcinoma]]''. | *May mimic ''[[adenoid cystic carcinoma]]''. | ||
*Classically base of tongue.<ref>URL: [http://www.biomedcentral.com/1471-2407/6/146 http://www.biomedcentral.com/1471-2407/6/146]. Accessed on: March 9, 2010.</ref> | *Classically base of [[tongue]].<ref>URL: [http://www.biomedcentral.com/1471-2407/6/146 http://www.biomedcentral.com/1471-2407/6/146]. Accessed on: March 9, 2010.</ref> | ||
*Typically poor prognosis. | *Typically poor prognosis. | ||
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*[[Basosquamous carcinoma]]. | *[[Basosquamous carcinoma]]. | ||
*[[Neuroendocrine tumour]]. | *[[Neuroendocrine tumour]]. | ||
==Clear cell squamous cell carcinoma== | |||
===General=== | |||
*Very rare.<ref name=pmid23798842>{{Cite journal | last1 = Lawal | first1 = AO. | last2 = Adisa | first2 = AO. | last3 = Olajide | first3 = MA. | last4 = Olusanya | first4 = AA. | title = Clear cell variant of squamous cell carcinoma of skin: A report of a case. | journal = J Oral Maxillofac Pathol | volume = 17 | issue = 1 | pages = 110-2 | month = Jan | year = 2013 | doi = 10.4103/0973-029X.110697 | PMID = 23798842 }}</ref> | |||
===Microscopic=== | |||
Features: | |||
*Clear cytoplasm. | |||
====Images==== | |||
<gallery> | |||
Image: SkinTumors-P5290109.JPG | Clear cell SCC. (WC) | |||
</gallery> | |||
==Lymphoepithelial (squamous cell) carcinoma== | ==Lymphoepithelial (squamous cell) carcinoma== | ||
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Images: see the ''[[LELC]]'' article. | Images: see the ''[[LELC]]'' article. | ||
=IHC= | |||
Features:<ref name=pmid20823766>{{Cite journal | last1 = Pereira | first1 = TC. | last2 = Share | first2 = SM. | last3 = Magalhães | first3 = AV. | last4 = Silverman | first4 = JF. | title = Can we tell the site of origin of metastatic squamous cell carcinoma? An immunohistochemical tissue microarray study of 194 cases. | journal = Appl Immunohistochem Mol Morphol | volume = 19 | issue = 1 | pages = 10-4 | month = Jan | year = 2011 | doi = 10.1097/PAI.0b013e3181ecaf1c | PMID = 20823766 }}</ref> | |||
*[[CK5/6]] +ve. | |||
*[[p63]] +ve. | |||
*K903 +ve. | |||
*[[p16]] +ve/-ve -- dependent on site, +ve favours non-lung SCC.<ref name=pmid20823766/> | |||
*[[p40]] +ve. | |||
Note: | |||
*Immunostains not particularly helpful for establishing primary site of squamous cell carcinoma. p16 may be helpful but is not definitive for non-lung SCC.<ref name=pmid20823766/> | |||
=See also= | =See also= | ||
*[[Adenocarcinoma]]. | *[[Adenocarcinoma]]. | ||
*[[Pseudoepitheliomatous hyperplasia]] - can mimic squamous cell carcinoma. | |||
*[[Basics]]. | *[[Basics]]. | ||
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