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Difference between revisions of "Squamous cell carcinoma of the skin"
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Squamous cell carcinoma of the skin (view source)
Revision as of 18:21, 21 September 2020
, 18:21, 21 September 2020no edit summary
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| Micro = | | Micro = | ||
| Subtypes = many see ''[[squamous cell carcinoma]]'' | | Subtypes = many see ''[[squamous cell carcinoma]]'' | ||
| LMDDx = [[inverted follicular keratosis]], [[Paget disease of the breast]], [[eccrine carcinoma]], [[atypical fibroxanthoma]], [[malignant melanoma]], [[leiomyosarcoma]], [[basal cell carcinoma]] (for ''[[basaloid squamous cell carcinoma]]'') | | LMDDx = [[inverted follicular keratosis]], [[Paget disease of the breast]], [[eccrine carcinoma]], [[atypical fibroxanthoma]], [[malignant melanoma]], [[leiomyosarcoma]], [[basal cell carcinoma]] (for ''[[basaloid squamous cell carcinoma]]''), [[porocarcinoma]], [[pseudoepitheliomatous hyperplasia]] | ||
| Stains = | | Stains = | ||
| IHC = CK5/6 +ve, p63 +ve, K903 +ve, Ber-EP4 -ve, S-100 -ve | | IHC = CK5/6 +ve, p63 +ve, K903 +ve, [[Ber-EP4]] -ve, S-100 -ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
| Line 14: | Line 14: | ||
| Gross = scaly patch or nodule, +/-ulceration | | Gross = scaly patch or nodule, +/-ulceration | ||
| Grossing = | | Grossing = | ||
| Staging = [[Squamous_cell_carcinoma_of_the_skin#Staging|squamous cell carcinoma of the skin staging]] | |||
| Site = [[skin]] - usu. sun exposed areas | | Site = [[skin]] - usu. sun exposed areas | ||
| Assdx = [[actinic keratosis]], [[solar elastosis]] | | Assdx = [[actinic keratosis]], [[solar elastosis]] | ||
| Line 79: | Line 80: | ||
*[[Eccrine carcinoma]]. | *[[Eccrine carcinoma]]. | ||
*[[Basal cell carcinoma]] for [[basaloid squamous cell carcinoma]]. | *[[Basal cell carcinoma]] for [[basaloid squamous cell carcinoma]]. | ||
*[[Porocarcinoma]]. | |||
*[[Pseudoepitheliomatous hyperplasia]]. | |||
===Grading=== | ===Grading=== | ||
| Line 88: | Line 91: | ||
====Images==== | ====Images==== | ||
<gallery> | <gallery> | ||
Image | Image: SkinTumors-P9020701.jpg | SCC - anaplastic. (WC) | ||
</gallery> | </gallery> | ||
| Line 118: | Line 121: | ||
*CK7 -ve. | *CK7 -ve. | ||
**Toker cells CK7 +ve.<ref name=pmid19601945>{{Cite journal | last1 = Nofech-Mozes | first1 = S. | last2 = Hanna | first2 = W. | title = Toker cells revisited. | journal = Breast J | volume = 15 | issue = 4 | pages = 394-8 | month = | year = | doi = 10.1111/j.1524-4741.2009.00743.x | PMID = 19601945 }}</ref> | **Toker cells CK7 +ve.<ref name=pmid19601945>{{Cite journal | last1 = Nofech-Mozes | first1 = S. | last2 = Hanna | first2 = W. | title = Toker cells revisited. | journal = Breast J | volume = 15 | issue = 4 | pages = 394-8 | month = | year = | doi = 10.1111/j.1524-4741.2009.00743.x | PMID = 19601945 }}</ref> | ||
Others: | |||
*[[Ber-EP4]] usually -ve.<ref name=pmid19187107>{{Cite journal | last1 = Yu | first1 = L. | last2 = Galan | first2 = A. | last3 = McNiff | first3 = JM. | title = Caveats in BerEP4 staining to differentiate basal and squamous cell carcinoma. | journal = J Cutan Pathol | volume = 36 | issue = 10 | pages = 1074-176 | month = Oct | year = 2009 | doi = 10.1111/j.1600-0560.2008.01223.x | PMID = 19187107 }}</ref> | |||
** Usually +ve in [[BCC]]. | |||
==Staging== | |||
===Tumour stage=== | |||
{| class="wikitable sortable" | |||
!T stage | |||
!Criteria | |||
!Comment | |||
|- | |||
| T1 | |||
| <=2 cm ''and'' less than two high-risk factors | |||
| see ''microscopic'' for list of high-risk factors | |||
|- | |||
| T2 | |||
| >2 cm and less than two high-risk factors ''or'' two or more high-risk factors | |||
| see ''microscopic'' for list of high-risk factors | |||
|- | |||
| T3 | |||
| tumour into nearby bone - maxilla, mandible, orbit, temporal bone | |||
| uncommonly seen by pathology | |||
|- | |||
| T4 | |||
| tumour into axial skeleton or appendicular skeleton or perineural invasion of skull base | |||
| basically never seen by pathology | |||
|} | |||
==Sign-out== | ==Sign-out== | ||
===Invasive SCC=== | ===Invasive SCC - small=== | ||
<pre>Scalp Lesion, Excision: | |||
- INVASIVE SQUAMOUS CELL CARCINOMA, well-differentiated. | |||
-- Margins NEGATIVE for carcinoma in situ and NEGATIVE for malignancy. | |||
--- Closest margin (deep margin): 4 mm. | |||
-- Maximal tumour dimension: 1.2 cm. | |||
-- NEGATIVE for lymphovascular invasion. | |||
-- NEGATIVE for perineural invasion. | |||
- Extensive solar elastosis. | |||
</pre> | |||
===Invasive SCC - large=== | |||
<pre> | <pre> | ||
Skin Lesion, Mid-Back, Excision: | Skin Lesion, Mid-Back, Excision: | ||