Histologic Subtyping and Malignancy Assessment of Cutaneous Squamous Cell Carcinoma

Petter, G.; Haustein, U.‐F.

doi:10.1046/j.1524-4725.2000.99181.x

Cited by 131 publications

(145 citation statements)

References 116 publications

(238 reference statements)

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“…13,20,23 In a study of 571 patients with cSCC, there was a significant difference in the rate of metastases from high-grade cSCC compared with lower grade cSCC (17% vs. 4%, respectively; P ϭ .004). 13 The incidence of poorly differentiated lesions in 1 series of patients with metastatic cSCC was increased significantly in patients who developed metastases (44% vs. 5%, respectively; PϽ.01).…”

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“…7 Similarly, there also are data demonstrating that desmoplastic SCC, although it is not reported commonly, is an aggressive histologic variant of cSCC with a high propensity to develop regional metastases, especially with increasing tumor thickness. 20,23 Using the Broder classification, 27% of patients in the study by Breuninger et al 20 had desmoplastic SCCs that were classified with a grade 4 differentiation compared with only 11% of patients who had nondesmoplastic cSCC. In the current study, almost half of the patients (46%) had tumors that were classified as moderately/poorly differentiated, and only 12% had tumors that were classified as well differentiated.…”

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High‐risk cutaneous squamous cell carcinoma of the head and neck

Veness

Palme

Morgan

2006

Cancer

219

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BACKGROUNDMost patients with cutaneous squamous cell carcinoma (cSCC) of the head and neck (HN) are at low‐risk (< 5%) of developing metastatic SCC to regional lymph nodes. However, patients with unfavorable clinicopathologic factors often are under appreciated by clinicians but remain at higher risk for developing metastatic lymph node disease and dying.METHODSPatients were identified who had metastatic cSCC to lymph nodes (parotid and cervical) of the HN and who were treated within the context of a multidisciplinary HN cancer service between 1980 and 2005 at Westmead Hospital (Sydney, Australia). Relevant patient details and data from primary lesions were analyzed and reported.RESULTSIn total, 266 patients were treated with curative intent. The median patient age was 69 years among 219 males and 47 females. The majority of metastatic lymph nodes (162 of 266 lymph nodes; 61%) were located in the parotid with or without cervical lymph node involvement. The median tumor thickness was 6 mm (range, 0.5–28 mm), and the median tumor size was 15 mm (range, 3–70 mm). Most tumors (65%) that measured ≥5 mm in thickness, and 30% of patients had lesions that measured ≥2 cm in greatest dimension. Recurrent cSCC was present in 15% of patients, and most lesions were located within the lymphatic drainage of the parotid on the temple/forehead (28%), on or around the ear (20%), or on the cheek (12%). Forty‐six percent of patients had moderately or poorly differentiated cSCC, and 5% of patients were immunosuppressed. A minority of patients (27%) did not have an identifiable index lesion.CONCLUSIONSData from this large, prospective data base, in concordance with other series, suggested that a patient with thick cSCC (>4–5 mm) located in proximity to the parotid gland can be considered at high‐risk. Increasing lesion size and recurrence contribute to this risk. Cancer 2006. © 2006 American Cancer Society.

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High‐risk cutaneous squamous cell carcinoma of the head and neck

Veness

Palme

Morgan

2006

Cancer

219

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“…However, HPV 16 and 18 have been detected in laryngeal VC, and HPV 6 and 11 infections appear to be associated with oral VC (2,17). Additionally, ano-urogenital VCs are closely associated with these viruses (18). There appears to be no association between HPV infection and rare cutaneous VC occurring at sites other than oral, ano-urogenital and palmoplantar regions (3).…”

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Immunohistochemical findings and differential diagnosis of papillary-type cutaneous verrucous carcinoma of the neck: A case report

et al. 2015

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Abstract. Verrucous carcinoma (VC) is a rare subtype of squamous cell carcinoma, with the majority of cases occurring in the oral cavity and genital area. The present study describes a rare case of cutaneous VC of the neck manifesting as a semi-pedunculated multinodular protrusion. Histological analysis revealed thickening of the epidermis and papillary growth. Although cellular atypia was generally mild, a large number of mitoses were observed, of which a small number were abnormal. Additionally, bulbous subepidermal invasion was observed. The lesion was differentiated from papillary squamous cell carcinoma, another rare subtype of squamous cell carcinoma, based on the presence of epidermal verrucous growth and the lack of remarkable nuclear atypia. Benign disorders, including seborrheic keratosis, fibroepithelial polyp, verruca vulgaris and pseudocarcinomatous hyperplasia, were also differentiated from the lesion. Immunohistochemical analysis of cytokeratin (CK)10 expression revealed attenuated staining of the lesion, therefore, anti-CK10 immunohistochemistry may be valuable in the diagnosis of VC.

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“…There is approximately 8-14 % incidence of regional or distant metastases with de novo SCCs (9). According to the classifi cation of cutaneous SCC in risk-based categories, SCC de novo has high malignant potential (>10 % risk) (10). De novo SCC has multiple cell atypia in histological fi nding and aggressive growth with high suspension of distinct metastases.…”

Section: Discussionmentioning

confidence: 99%

Anogenital squamous cell carcinoma in neglected patient

Svecova

Havránková²,

E³

et al. 2012

BLL

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Skin squamous cell carcinomas (SCCs) are arguably the second most common carcinoma of the skin and are responsible for the majority of non-melanoma skin cancer deaths. Gynecologist treated a Caucasian 56-years old female patient for genital wart with podophyllotoxin cream. She did not achieve complete response and therefore she has interrupted the therapy and the collaboration with the gynecologist. At the time of evaluation the lesion had a size of man's palm in anogenital region and showed characteristic features of neoplasm. The regional lymph nodes have produced infi ltrated painful bubo. PCR analysis for HPV proved negative. Histopathology revealed well-differentiated squamous cell keratinizing carcinoma from the tumor as well as from the regional lymph node packet. Staging computed tomography scans proved negative and pelvis scans disclosed regional lymphadenopathy underlying the tumor. Palliative radiation therapy (by linear accelerator) was administered for the oversized tumor to the total TD 50.0Gy. The patient died 6 months after diagnostic assessment from cardio-respiratory failure. Staging computed tomography before her death did not disclose distinct metastases in her inner organs. Well-differentiated squamous cell keratinizing carcinoma could be growing endophytically affecting the underlying adipose tissue and musculature, with spreading into the regional lymph nodes. The rate of metastases into inner organs seems to vary according to the aggressiveness and metastatic behavior of each SCC. The case report calls for attention to the importance of collaboration among various specialists assisting in the diagnosis and management of skin neoplasm (Fig. 5, Ref. 12 Non-melanoma skin cancer is the most common cancer in human and the squamous cell carcinoma (SCC) is arguably the second most common carcinoma of the skin. SCC is responsible for the majority of non-melanoma skin cancer deaths and the incidence of SCC depends on the selection of patients included into the study (1). The overall rate of metastases and local recurrence is, except in high-risk cases, less than 10 % (2). Males are more frequently affected than females with the average age being approximately 70 years (3). About 90 % of all SCC are located on UV-exposed sites of the body, especially on the head and face (4). The UV light is the most important etiologic factor (5). Of signifi cance is the oncogenic potential of X-rays, arsenic, tar, and HPV infection (6). Immunosuppressed patients (e.g. transplant recipients) are in high risk of both, the carcinoma development and metastases spreading (7). Individuals suffering from genodermatoses, such as xeroderma pigmentosum, albinism, and epidermodysplasia verruciformis are at increased risk for SCC (8). We would like to draw further attention to this issue with a case of a neglected well-differentiated squamous cell keratinizing carcinoma. Case reportGynecologist treated a Caucasian 56-year-old female patient for genital wart with podophylloxin cream of 0.5 %. The patient did not ach...

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Histologic Subtyping and Malignancy Assessment of Cutaneous Squamous Cell Carcinoma

Abstract: The future outcome of SCCs of the skin is significantly influenced by their histologic grade and tumor thickness. In addition, subtyping represents another valuable histopathologic tool for improving the assessment of malignancy.

Cited by 131 publications

References 116 publications

High‐risk cutaneous squamous cell carcinoma of the head and neck

High‐risk cutaneous squamous cell carcinoma of the head and neck

Immunohistochemical findings and differential diagnosis of papillary-type cutaneous verrucous carcinoma of the neck: A case report

Anogenital squamous cell carcinoma in neglected patient

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