Squamous-cell carcinoma

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Squamous cell carcinomas
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Main histopathology features of squamous-cell carcinoma

Squamous-cell carcinoma (SCC), also known as epidermoid carcinoma, comprises a number of different types of

digestive tracts.[1]

Despite sharing the name "squamous-cell carcinoma", the SCCs of different body sites can show differences in their presented symptoms, natural history, prognosis, and response to treatment.

By body location

Human papillomavirus infection has been associated with SCCs of the oropharynx, lung,[2] fingers,[3] and anogenital region.

Head and neck cancer

A large head and neck squamous-cell carcinoma of the tongue as seen on CT imaging

About 90%[4] of cases of head and neck cancer (cancer of the mouth, nasal cavity, nasopharynx, throat and associated structures) are due to SCC.

Skin

Cutaneous squamous-cell carcinoma is the second most common skin cancer, accounting for over 1 million cases in the United States each year.[5]

Thyroid

Primary squamous-cell carcinoma of the thyroid shows an aggressive biological phenotype resulting in poor prognosis for patients.[6]

Esophagus

Esophageal cancer may be due to either esophageal squamous-cell carcinoma (ESCC) or adenocarcinoma (EAC). SCCs tend to occur closer to the mouth, while adenocarcinomas occur closer to the stomach. Dysphagia (difficulty swallowing, solids worse than liquids) and painful swallowing are common initial symptoms. If the disease is localized, surgical removal of the affected esophagus may offer the possibility of a cure. If the disease has spread, chemotherapy and radiotherapy are commonly used.[7]

Lung

Photograph of a squamous-cell carcinoma. The tumour is on the left, obstructing the bronchus (lung); beyond the tumour, the bronchus is inflamed and contains mucus.

When associated with the lung, it is typically a centrally located large-cell cancer (

hypercalcemia, but paraneoplastic syndrome is more commonly associated with small-cell lung cancer. It is primarily due to smoking.[8]

Penis

Human papillomavirus
(HPV), primarily HPV 16 and 18, are strongly implicated in the development of SCC of the penis. Three carcinomas in situ are associated with SCCs of the penis:[
citation needed]

  1. Bowen's disease
    presents as leukoplakia on the shaft. Around a third of cases progress to SCC.
  2. Erythroplasia of Queyrat
    , a variation of Bowen's disease, presents as erythroplakia on the glans.
  3. Bowenoid papulosis, which histologically resembles Bowen disease, presents as reddish papules.[9]

Prostate

When associated with the

prostate-specific antigen levels is seen, meaning that the cancer is often diagnosed at an advanced stage.[citation needed
]

Vagina and cervix

Squamous-cell carcinoma of the vagina spreads slowly and usually stays near the vagina, but may spread to the lungs and liver. This is the most common type of vaginal cancer.[10]

Ovary

Ovarian squamous cell carcinoma (oSCC) or squamous ovarian carcinoma (SOC) is a rare tumor that accounts for 1% of ovarian cancers.[11]

Bladder

Most bladder cancer is transitional cell, but bladder cancer associated with schistosomiasis is often SCC.[citation needed]

Eye

Conjunctival squamous cell carcinoma and corneal intraepithelial neoplasia comprise ocular surface squamous neoplasia (OSSN).

Diagnosis

Biopsy of a highly differentiated squamous-cell carcinoma of the mouth. Typical squamous-cell carcinoma cells are large with abundant eosinophilic cytoplasm and large, often vesicular, nuclei.[12] Haematoxylin & eosin stain
Cytopathology of squamous-cell carcinoma, keratinizing variant, with typical features.[13] Pap stain.
Cytopathology of squamous-cell carcinoma, nonkeratinizing variant, with typical features.[14] Pap stain. Yet, these findings are overall less specific than for keratinizing squamous-cell carcinoma, and most can be seen in other cancers such as adenocarcinoma as well (which, however, tends to have fine chromatin).[15]

Medical history, physical examination and medical imaging may suggest a squamous-cell carcinoma, but a biopsy for histopathology generally establishes the diagnosis. TP63 staining is the main histological marker for squamous-cell carcinoma. In addition, TP63 is an essential transcription factor to establish identity of the squamous cells.[16]

  • SCC well-differentiated, left upper paraspinal back marked for biopsy with adjacent actinic keratosis
    SCC well-differentiated, left upper paraspinal back marked for biopsy with adjacent actinic keratosis
  • SCC, left lateral canthus marked for biopsy
    SCC, left lateral canthus marked for biopsy
  • SCC, left ventral forearm
    SCC, left ventral forearm

Classification

Cancer can be considered a very large and exceptionally heterogeneous family of malignant diseases, with squamous-cell carcinomas comprising one of the largest subsets.

invasive" squamous-cell carcinoma. Once a carcinoma becomes invasive, it is able to spread to other organs and cause the formation of a metastasis, or "secondary tumor".[citation needed
]

Tissue of origin

The

malignant squamous-cell neoplasms, including:[20]

Other variants of SCCs are recognized under other systems, such as keratoacanthoma.

Other histopathologic subtypes

  • Erythroplasia of Queyrat
  • Marjolin's ulcer is a type of SCC that arises from a nonhealing ulcer or burn wound. More recent evidence, however, suggests that genetic differences exist between SCC and Marjolin's ulcer, which were previously underappreciated.[23]

One method of classifying squamous-cell carcinomas is by their appearance under microscope. Subtypes may include:

  • Adenoid squamous-cell carcinoma
    Adenoid squamous-cell carcinoma
  • Basaloid squamous-cell carcinoma
    Basaloid squamous-cell carcinoma
  • Clear-cell squamous-cell carcinoma
    Clear-cell squamous-cell carcinoma
  • Spindle-cell squamous-cell carcinoma
    Spindle-cell squamous-cell carcinoma


Prevention

Studies have found evidences for an association between diet and skin cancers, including SCC. The consumption of high-fat dairy foods increases SCC tumor risk in people with previous skin cancer. Green leafy vegetables may help prevent development of subsequent SCC and multiple studies found that raw vegetables and fruits are significantly protective against SCC risk.[25][26] On the other hand, consumption of whole milk, yogurt, and cheese may increase SCC risk in susceptible people.[27] In addition, meat and fat dietary pattern can increase the risk of SCC in people without a history of SCC, but the association is again more prominent in people with a history of skin cancer.[28] Tobacco smoking and a dietary pattern characterized by high beer and liquor intake also increase the risk of SCC significantly.[29][25]

References

  1. ^ a b "NCI Dictionary of Cancer Terms". National Cancer Institute. 2011-02-02. Retrieved 9 November 2016.
  2. PMID 19424646
    .
  3. ^ "Recurrent Squamous Cell Carcinoma In Situ of the Finger". Retrieved 2010-09-22.
  4. ^ "Types of head and neck cancer - Understanding - Macmillan Cancer Support". Retrieved 15 March 2017.
  5. PMID 28722968
    , retrieved 2022-03-09
  6. .
  7. ^ "Esophageal Cancer". The Lecturio Medical Concept Library. 26 October 2020. Retrieved 6 August 2021.
  8. .
  9. .
  10. ^ "Squamous-cell Carcinoma of the Vagina". www.dynamed.com. Retrieved 2018-02-20.
  11. PMID 28658855
    .
  12. ^ Dr Nicholas Turnbull, A/Prof Patrick Emanual (2014-05-03). "Squamous cell carcinoma pathology". DermNetz.
  13. ^ - Image annotated by Mikael Häggström
    - Reference for entries: Gulisa Turashvili, M.D., Ph.D. "Cervix - Squamous cell carcinoma and variants". Pathology Outlines.{{cite web}}: CS1 maint: multiple names: authors list (link) Last author update: 24 September 2020. Last staff update: 4 April 2022.
    - Source image from National Cancer Institute (Public Domain)
  14. ^ - Image annotated by Mikael Häggström
    - Reference for entries: Gulisa Turashvili, M.D., Ph.D. "Cervix - Squamous cell carcinoma and variants". Pathology Outlines.{{cite web}}: CS1 maint: multiple names: authors list (link) Last author update: 24 September 2020. Last staff update: 4 April 2022.
    - Source image by Ravi Mehrotra, Anurag Gupta, Mamta Singh and Rahela Ibrahim (Creative Commons Attribution 2.0 Generic license.)
  15. ^ Authors: Caroline I.M. Underwood, M.D., Alexis Musick, B.S., Carolyn Glass, M.D., Ph.D. "Adenocarcinoma overview". Pathology Outlines.{{cite web}}: CS1 maint: multiple names: authors list (link) Last staff update: 19 July 2022
  16. PMID 32128997
    .
  17. .
  18. .
  19. (PDF) on 23 August 2009. Retrieved 27 March 2010.
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