Difference between revisions of "Squamous cell carcinoma"

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Squamous cell carcinoma (view source)

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[[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]]'''.
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]]'''.


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{{Main|Squamous cell carcinoma of the 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===
*[[Anus]].
*[[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.
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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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*[[Wart]].
*[[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]].


Michael
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