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Difference between revisions of "Squamous cell carcinoma of the urinary bladder"
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Squamous cell carcinoma of the urinary bladder (view source)
Revision as of 16:50, 14 February 2018
, 16:50, 14 February 2018→Subclassification
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| Micro = | | Micro = | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[metastatic]] squamous cell carcinoma (esp. [[squamous cell carcinoma of the uterine cervix]]), [[urothelial carcinoma]] with squamous differentiation, [[condyloma acuminatum]], [[squamous dysplasia]] | | LMDDx = [[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]] | ||
| Stains = | | Stains = | ||
| IHC = p16 -ve/+ve | | IHC = p16 -ve/+ve, CK20 -ve, CK7 -ve, CK14 +ve, GATA3 -ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
| Line 20: | Line 20: | ||
| Clinicalhx = lived in areas with ''Schistosoma haematobium'' | | Clinicalhx = lived in areas with ''Schistosoma haematobium'' | ||
| Signs = | | Signs = | ||
| Symptoms = | | Symptoms = hematuria | ||
| Prevalence = very rare | | Prevalence = very rare | ||
| Bloodwork = | | Bloodwork = | ||
| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = | | Prognosis = similar to UCC of the bladder | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = other bladder tumours | ||
| Tx = | | Tx = cystectomy | ||
}} | }} | ||
'''Squamous cell carcinoma of the urinary bladder''', abbreviated '''SCC of the bladder''', is a rare [[cancer]] of the [[urinary bladder]]. | '''Squamous cell carcinoma of the urinary bladder''', abbreviated '''SCC of the bladder''', is a rare [[cancer]] of the [[urinary bladder]]. | ||
| Line 38: | Line 38: | ||
**Common in areas with ''S. haematobium''. | **Common in areas with ''S. haematobium''. | ||
**Uncommon in areas without ''S. haematobium''. | **Uncommon in areas without ''S. haematobium''. | ||
*Five year survival of SCC of the bladder is similar to UCC of the bladder.<ref name=pmid26199176 >{{Cite journal | last1 = Izard | first1 = JP. | last2 = Siemens | first2 = DR. | last3 = Mackillop | first3 = WJ. | last4 = Wei | first4 = X. | last5 = Leveridge | first5 = MJ. | last6 = Berman | first6 = DM. | last7 = Peng | first7 = Y. | last8 = Booth | first8 = CM. | title = Outcomes of squamous histology in bladder cancer: a population-based study. | journal = Urol Oncol | volume = 33 | issue = 10 | pages = 425.e7-13 | month = Oct | year = 2015 | doi = 10.1016/j.urolonc.2015.06.011 | PMID = 26199176 }}</ref> | |||
**Unadjusted five year survival of UCC, SCC and UCC with squamous differentiation is 34%, 33% and 28% respectively. | |||
===Subclassification=== | |||
Divided into two subtypes: <ref name=pmid27547458>{{Cite journal | last1 = Martin | first1 = JW. | last2 = Carballido | first2 = EM. | last3 = Ahmed | first3 = A. | last4 = Farhan | first4 = B. | last5 = Dutta | first5 = R. | last6 = Smith | first6 = C. | last7 = Youssef | first7 = RF. | title = Squamous cell carcinoma of the urinary bladder: Systematic review of clinical characteristics and therapeutic approaches. | journal = Arab J Urol | volume = 14 | issue = 3 | pages = 183-91 | month = Sep | year = 2016 | doi = 10.1016/j.aju.2016.07.001 | PMID = 27547458 }}</ref> | |||
*Bilharzial-associated SCC (BSCC) - not associated with bilharziasis (Schistosoma). | |||
*Non-bilharzial SCC (NBSCC). | |||
Characteristics of NBSCC:<ref name=pmid27547458/> | |||
*Prevalance ~2-5% of bladder tumours (in Western countries).<ref>URL: [https://www.myvmc.com/diseases/bladder-cancer-squamous-cell-carcinoma-of-the-bladder/ https://www.myvmc.com/diseases/bladder-cancer-squamous-cell-carcinoma-of-the-bladder/]. Accessed on: 14 February 2018.</ref> | |||
*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== | ==Microscopic== | ||
| Line 50: | Line 65: | ||
*[[Condyloma acuminatum]]. | *[[Condyloma acuminatum]]. | ||
*[[Squamous dysplasia]]. | *[[Squamous dysplasia]]. | ||
*[[Keratinising squamous metaplasia of the urinary bladder]]. | |||
==IHC== | ==IHC== | ||
| Line 55: | Line 71: | ||
*p16 -ve/+ve. | *p16 -ve/+ve. | ||
**Not definite for separating from cervix - but suggestive: cervix ~86% +ve, bladder ~37% +ve.<ref name=pmid20571342>{{Cite journal | last1 = Cioffi-Lavina | first1 = M. | last2 = Chapman-Fredricks | first2 = J. | last3 = Gomez-Fernandez | first3 = C. | last4 = Ganjei-Azar | first4 = P. | last5 = Manoharan | first5 = M. | last6 = Jorda | first6 = M. | title = P16 expression in squamous cell carcinomas of cervix and bladder. | journal = Appl Immunohistochem Mol Morphol | volume = 18 | issue = 4 | pages = 344-7 | month = Jul | year = 2010 | doi = 10.1097/PAI.0b013e3181d2bbd7 | PMID = 20571342 }}</ref> | **Not definite for separating from cervix - but suggestive: cervix ~86% +ve, bladder ~37% +ve.<ref name=pmid20571342>{{Cite journal | last1 = Cioffi-Lavina | first1 = M. | last2 = Chapman-Fredricks | first2 = J. | last3 = Gomez-Fernandez | first3 = C. | last4 = Ganjei-Azar | first4 = P. | last5 = Manoharan | first5 = M. | last6 = Jorda | first6 = M. | title = P16 expression in squamous cell carcinomas of cervix and bladder. | journal = Appl Immunohistochem Mol Morphol | volume = 18 | issue = 4 | pages = 344-7 | month = Jul | year = 2010 | doi = 10.1097/PAI.0b013e3181d2bbd7 | PMID = 20571342 }}</ref> | ||
*CK14 +ve.<ref name=pmid25643514>{{Cite journal | last1 = Hammam | first1 = O. | last2 = Wishahiz | first2 = M. | last3 = Khalil | first3 = H. | last4 = El Ganzouri | first4 = H. | last5 = Badawy | first5 = M. | last6 = Elkhquly | first6 = A. | last7 = Elesaily | first7 = K. | title = Expression of cytokeratin 7, 20, 14 in urothelial carcinoma and squamous cell carcinoma of the Egyprian urinary bladder cancer. | journal = J Egypt Soc Parasitol | volume = 44 | issue = 3 | pages = 733-40 | month = Dec | year = 2014 | doi = | PMID = 25643514 }}</ref> | |||
*CK7 -ve.<ref name=pmid25643514/> | |||
*CK20 -ve.<ref name=pmid25643514/> | |||
===UCC versus SCC=== | |||
IHC may be of some use as per Gulmann ''et al.'':<ref name=pmid22995333>{{Cite journal | last1 = Gulmann | first1 = C. | last2 = Paner | first2 = GP. | last3 = Parakh | first3 = RS. | last4 = Hansel | first4 = DE. | last5 = Shen | first5 = SS. | last6 = Ro | first6 = JY. | last7 = Annaiah | first7 = C. | last8 = Lopez-Beltran | first8 = A. | last9 = Rao | first9 = P. | title = Immunohistochemical profile to distinguish urothelial from squamous differentiation in carcinomas of urothelial tract. | journal = Hum Pathol | volume = 44 | issue = 2 | pages = 164-72 | month = Feb | year = 2013 | doi = 10.1016/j.humpath.2012.05.018 | PMID = 22995333 }}</ref> | |||
{| class="wikitable sortable" | |||
! 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:<ref name=pmid25643514>{{Cite journal | last1 = Hammam | first1 = O. | last2 = Wishahiz | first2 = M. | last3 = Khalil | first3 = H. | last4 = El Ganzouri | first4 = H. | last5 = Badawy | first5 = M. | last6 = Elkhquly | first6 = A. | last7 = Elesaily | first7 = K. | title = Expression of cytokeratin 7, 20, 14 in urothelial carcinoma and squamous cell carcinoma of the Egyprian urinary bladder cancer. | journal = J Egypt Soc Parasitol | volume = 44 | issue = 3 | pages = 733-40 | month = Dec | year = 2014 | doi = | PMID = 25643514 }}</ref> | |||
{| class="wikitable sortable" | |||
! Immunostain | |||
! SCC | |||
! UCC | |||
|- | |||
| CK7 | |||
| 0% (0/50) | |||
| 80% (120/150) | |||
|- | |||
| CK20 | |||
| 0% (0/50) | |||
| 70% (105/120) | |||
|} | |||
==Sign out== | |||
In areas not endemic for ''S. haematobium'', reports of biopsies should raise the possibility of UCC with squamous differentiation and metastasis. | |||
==See also== | ==See also== | ||