Sclerosing Squamous Cell Carcinoma of the Skin, An Underemphasized Locally Aggressive Variant: A 20-Year Experience

Abstract

Our results suggest that desmoplasia is uncommonly found in association with cutaneous SCC but helps define a locally aggressive variant of carcinoma. In light of the infiltrative nature of desmoplastic SCC of the skin and the high incidence of perineural invasion, micrographic surgery is the surgical modality of choice.

Spindle Cell Neoplasms Encountered in Dermatologic Surgery: A Review

“…Spindle cell SCC stains strongly with high‐molecular weight cytokeratin antibodies (CK5/6, 34βE12) and does not stain with S‐100 and smooth muscle actin, differentiating these tumors from DM and LMS, respectively. It has been postulated that pan‐keratin, 34βE12, and p63 are the most‐specific markers for spindle cell SCC (Figure B) . Several recent studies have also found a panel including p63 and CD10 to be helpful in differentiating these tumors from AFX; SCC stains more commonly with p63, whereas nearly all AFX stain with CD10 .…”

“…This feature is instead characteristic of the desmoplastic variant of SCC, a more clinically aggressive histologic subtype appearing as trabeculae of keratinized, rather than spindle, cells on histologic examination . Rarely, tumors may display features of desmoplastic and spindle cell SCC, and these neoplasms have been associated with a propensity for clinical aggression …”

“…[110][111][112] Rarely, tumors may display features of desmoplastic and spindle cell SCC, and these neoplasms have been associated with a propensity for clinical aggression. 113 Particularly when histologic signs of keratinization are absent, immunohistochemistry serves a helpful role in distinguishing spindle cell SCC from other similar-appearing tumors such as AFX, DM, and LMS ( Table 1). Spindle cell SCC stains strongly with high-molecular weight cytokeratin antibodies (CK5/6, 34βE12) and does not stain with S-100 and smooth muscle actin, differentiating these tumors from DM and LMS, respectively.…”

The prognostic value of tumor-stroma proportion in laryngeal squamous cell carcinoma

“…Tumor-stroma ratio or tumor-stroma proportion (TSP) has been presented as a prognostic factor in some types of carcinomas, including prostate, colorectal, esophageal and breast adenocarcinomas (5-11). Additionally, desmoplasia is presented as a poor prognostic factor in colon and lung adenocarcinoma (12)(13)(14) and in squamous cell carcinomas (SCC) ofthe skin and the desmoplastic variant of skin SCC is known as a very aggressive tumor (15)(16)(17)(18). There is no information about TSP of SGG and laryngeal carcinomas, in particular.…”

Early invasive squamous cell carcinoma recurrence rates: A study examining surgical margins, tumor surface diameter, invasion depth, and grade of differentiation in 1296 cases over 9 years

“…2 Increased tumor diameter beyond 20 mm, 3,4 tumor invasion deeper than 2.0 mm 5,6 and a shift towards poor differentiation 3,7 indicate higher risk SCC. Risk allocation can also be influenced by other factors including anatomic site, 8 desmoplasia, 9 perineural invasion, 3 a high mitotic count, 10 tumor budding, 11 and host immune status. 12 Prominent surface keratin is a common feature on welldifferentiated SCC.…”