Desmoplastic squamous cell carcinoma of skin and vermilion surface

Abstract

tion, degree of keratinization, location, and immunosuppression. The determination of whether desmoplasia, previously described in only one case of SCC, consti-1 Dermatological Clinic, University of Tübingen tutes an additional prognostic factor was the objective of this study. School of Medicine, Tübingen, Germany. METHODS.The study was performed prospectively on 594 SCCs from 509 patients. Institute of Pathology, University of TübingenAll of the factors mentioned earlier were present. Forty-four SCCs were identified School of Medicine, Tübingen, Germany.by light microscopy as desmoplastic due to their prominent trabecular growth patterns, narrow columns of atypical epithelial cells, and marked desmoplastic stromal reaction, in some cases with perineural and perivascular invasion. Followup ranged from 4 to 10 years (median, 5.3 years). RESULTS.All tumors in the study patient population were treated using the paraffin section method of micrographic surgery. The 44 desmoplastic SCCs were found to metastasize 6 times more often than the remaining 550 tumors (22.7% vs. 3.8%), with 10 times as many local recurrences (27.3% vs. 2.6%). CONCLUSIONS.Desmoplasia is a highly significant (P õ 0.001) prognostic factor for SCCs and is associated with the development of metastases or recurrence.

Desmoplastic spindle cell squamous cell carcinoma of skin

“…The present tumor is carcinoma. Atypical fibroxanthoma and desmoplastic melanoma was excluded because the present tumor expressed various CKs and did not express HMB45, Melan-A, SOX10, MITF; [3][4][5][6][7][8][9][10] the specificity of S100 protein is low, [3][4][5][6][7][8][9][10] the possibility of desmoplastic melanoma is quite unlikely. Because the present tumor expressed CKs, it is carcinoma.…”

“…Desmoplastic SCC is a variant of cutaneous SCC, and it is very rare. [1][2][3] Breunonger et al [2] reported 44 cases (7%) of desmoplastic SCC out of 594 cutaneous SCCs. They showed that the local recurrernce, metastasis and mortality were higher in desmoplastic SCC than in ordinary cutaneous SCC.…”

“…They showed that the local recurrernce, metastasis and mortality were higher in desmoplastic SCC than in ordinary cutaneous SCC. Velazquez et al [3] reported 6 cases of cutaneous desmoplastic SCC, and found that they showed high recurrence, median age of 72 years, predominant occurrence of sun-exposed skin, high mortality, male predominance, predomiant development of head and neck skin, high infiltrative features. Spindle cell SCC is also rare.…”

“…[4][5][6][7][8][9][10] These two variants of skin SCC lack keratinization and intercellular bridge, thus causing diagnostic problems. [1][2][3][4][5][6][7][8][9][10] The author herein reports a case of desmoplastic SCC composed predominantly of spindle cells.…”

High-risk Cutaneous Squamous Cell Carcinoma

“…32 Desmoplastic tumors, in particular, have been shown to carry higher risk of metastasis, with Breuninger et al highlighting 6 times more metastases and 10 times more recurrences where desmoplastic subtypes were identified in a sample of 509 patients with cSCC. 19 To date, these histological details have not been included in AJCC guidelines. Perineural and lymphovascular invasion have both been highlighted as risk factors for nodal spread of disease in cSCC.…”