Cutaneous squamous cell carcinoma with osteoclast-like giant cells in an 87-year-old male

Abstract

Cutaneous Squamous Cell Carcinoma (SCC) with Osteoclast-Like Giant Cells (OLGCs) is a rare finding, with only 11 previous cases reported in the literature. The origin of the OLGC within carcinomas has been debated, and there are two prevailing theories regarding the cell origin. We report the 12th case of SCC with OLGCs, discuss the two theories, and analyze the common features among all twelve cases. Ultimately, there appears to be an association between OLGCs and poorly differentiated cutaneous squamous cell carcinomas. Consequently, OLGCs should lead to an increased index of suspicion, as they may be a predictor of poor outcomes. If OLGCs are identified on histology, the pathologist should consider the addition of Preferentially-expressed Antigen in Melanoma (PRAME) immunostaining as a means of more accurately determining the prognosis. In conjunction with clinical features, histology should guide clinical recommendations and may warrant chemoprevention with systemic retinoids in high-risk individuals.